Managing type 2 diabetes whilst fasting during Ramadan
Trying to manage your diet with type 2 diabetes while fasting is no easy task. Although it has been scientifically proven that fasting has many health benefits and can help with managing blood sugar levels, fasting can result in negative side effects as outlined below.
What can happen to your body during fasting?
Overall, the risks associated with fasting if you have type 2 diabetes vary and can depend on:
- Whether you are currently keeping your average blood sugar level in a healthy range.
- The type of medication you use to manage your diabetes. Some medications like insulin and sulphonylureas can increase the risk of low blood sugar (hypoglyceamia)
- Whether you’re living with type 2 diabetes complications such as poor vision, nerve damage, or heart or kidney disease as fasting could affect these health conditions.
Fasting can also lead to:
- High blood sugar levels.
- Constipation. 1
It is therefore important to make healthy dietary and lifestyle choices during Ramadan to help you stay well.
Aim to consult your healthcare provider before beginning any fasting if you are unsure of your suitability. Consulting a health care professional can help you identify whether it is safe for you to fast and can also help you plan how best to fast.
For example, your plan may include:
- Increasing your blood sugar tests during your fast to ensure that you do not have low blood sugars.
- Adjusting the dose of your diabetes tablets or insulin as you may not need as much before the start of the fast or changing the time you take your diabetes tablets or insulin.
- Identifying what to do if your blood sugar is too low or too high, or if you become unwell.
The Qur’an allows you not to fast if you have an illness or medical condition. So, if you are getting to a point where you feel that it’s no longer safe for you to continue to fast, you could also consider reaching out to your local Imam for advice and to learn about other options available during Ramadan, such as donations or charity activities.1, 2
Aim to eat healthily during Ramadan
Here are more tips to help you stay on track with your healthy eating during Ramadan.
Tips for Sehri (pre-sunrise meal)
1. Don’t skip your pre-sunrise meal (Sehri).
Try planning your sehri meal the night before if you are pushed for time. We have lots of low-carb recipes on our portal like our overnight berry pots, low-carb meal prep breakfast bowl or chickpea shakshuka that can be prepared in advance. You can have a look within our members area for more ideas
2. Stay hydrated
Aim to stay hydrated during sehri with low-carb drinks.
Keep hydrated by drinking plenty of water between sunset and sunrise. Please have a look at our drinks list for more tips.
3. Break your fast right
- Try not to break your fast with pastries, high-sugar breakfast cereals, high carbohydrate breads, fried foods, and sugary and caffeinated drinks.
- Try to opt for low-carb fruits and vegetables and fibre-rich foods that have a lower glycaemic index, such as beans and brown rice, as these will release energy more slowly and allow you to keep your energy levels up for longer.
- Try including protein-rich foods such as eggs, lentils, beans or chickpeas; alongside dairy foods like yoghurts and milk-rich foods as well as plenty of fluids. 3,5
Tips for a healthy Iftar:
It is not easy to fast from dawn till dusk and it can be tempting to overindulge with family and friends when you break your fast at Iftar. However, it is important not to overeat or overindulge when you break your fast as this can raise your blood sugar levels, cause bloating and increase your risk of weight gain. For a healthy Iftar you could aim to:
- Split your meals evenly between sehri and iftar to help you better manage your blood sugar levels.
- Break your fast with low-carb meals and desserts from our recipe portal to help you stay on track as shown in the example below.
- Aim to base your meals on ‘Our Food Plate Guide’ to help you get the portions right for all the food groups.
- Remember that planning and cooking your own meals in advance can help you make healthy choices even when you eat Iftar with friends and family. Please see our guide on ‘Meal Planning’ for more tips on how to stay on top of your meals during Ramadan. Please also see our guide on ‘Staying Social’ for tips on how to stay on track when you break your fast with friends and family.
Please remember that if you start to feel unwell or weak during Ramadan, it’s important you reach out to your doctor immediately. Further nutritional information can be found through the International Diabetes Federation and the DAR International Alliance guidelines (with an App available too) at http://www.daralliance.org/daralliance/
If you are looking for help to manage your condition, we are here to support you to self-manage your diabetes for long-term better health.
Find out more about the help and programmes available from Diabetes Lifestyle Doctors by clicking here.
- Lee, J. Y., Wong, C. P., Tan, C. S. S., Nasir, N. H., & Lee, S. W. H. (2017). Type 2 diabetes patient’s perspective on ramadan fasting: A qualitative study. BMJ Open Diabetes Research and Care, 5(1). https://doi.org/10.1136/bmjdrc-2016-000365
- Diabetes UK. Diabetes and Ramadan. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/ramadan#:~:text=High%20fibre%20starchy%20foods%20like,range%20whilst%20you’re%20fasting. Accessed April 2022
- Diabetes on the net. Fasting and feasting safely with type 2 diabetes in the month of Ramadan. https://diabetesonthenet.com/journal-diabetes-nursing/fasting-and-feasting-safely-type-2-diabetes-month-ramadan/ Accessed April 2022.
- Ibrahim, M., Davies, M. J., Ahmad, E., Annabi, F. A., Eckel, R. H., Ba-Essa, E. M., el Sayed, N. A., Hess Fischl, A., Houeiss, P., Iraqi, H., Khochtali, I., Khunti, K., Masood, S. N., Mimouni-Zerguini, S., Shera, S., Tuomilehto, J., & Umpierrez, G. E. (2020). Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus. In BMJ Open Diabetes Research and Care(Vol. 8, Issue 1). https://doi.org/10.1136/bmjdrc-2020-001248
- Diabetes on the net. Fasting and Feasting Safely. https://diabetesonthenet.com/journal-diabetes-nursing/fasting-and-feasting-safely-type-2-diabetes-month-ramadan/) Accessed April 2022
- International Diabetes Federation. Diabetes and Ramadan: Practical Guidelines 2017. https://www.idf.org/e-library/guidelines/87-diabetes-and-ramadan-practical-25.html. Accessed April 2022.