Prepare for a healthy Ramadan
What I should know about managing
my type 2 diabetes during Ramadan
www.diabetesalliance.co.uk
This booklet is part of Dialogue, a patient support programme. It has been
developed and funded by AstraZeneca in conjunction with TREND-UK.
Ramadan
The period of Ramadan is one of the holiest months in the Islamic calendar.
It is when the Qur’an was revealed. Ramadan lasts from sunrise (sahur)
to sunset (iftar). Millions of practising Muslims around the world take part
in Ramadan to receive spiritual reward from God, have their sins forgiven,
and practice self-restraint.
Can I fast if I have diabetes?
If you have type 2 diabetes it might not be suitable for you to fast.
Not fasting due to ill health follows Islamic principles. This can be
discussed further with your local imam (moulvi).
The holy Qur’an exempts those with medical conditions from fasting,
particularly if it could have harmful consequences to your health.
As you have diabetes, you fall into this category. However, you may
still wish to fast.
If you are unsure whether you can fast or not, it is important to consult
your doctor, nurse or pharmacist to discuss it further.
This leaflet is not intended to be a substitute for the advice of your doctor, nurse or pharmacist.
Ask your healthcare professional for further information.
What are the risks of fasting when
I have diabetes?
During the month of Ramadan, if not managed well, fasting can lead
to the following problems:
•Hyperglycaemia – This is when your blood glucose levels
are too high. This can be because of poor diet or if you have changed your
medication dose. Symptoms include:
–
–
–
–
thirst
passing more urine than normal
tiredness
headaches.
If you experience hyperglycaemic episodes, talk to your doctor or nurse
to see if you are able to continue fasting.
•Hypoglycaemia (or hypo) – This is when your blood glucose levels
are too low (below 4mmol/L). Symptoms may include:
–
–
–
–
f eeling shaky
s weating
f eeling hungry
tiredness
– g
oing pale
– blurred vision
– not being able
to concentrate
– headaches
– feeling emotional
– feeling moody
or angry.
This may happen if you are using insulin or certain diabetes tablets
(Check with your diabetes nurse or pharmacist to see if you are at risk).
Talk to your doctor or nurse about how frequently you should monitor your
blood glucose levels during Ramadan and what to do if you experience a ‘hypo’.
If left untreated, hypoglycaemia can be dangerous. Treat immediately
with one of the following:
•5 -6 dextrose tablets
•100 mL Lucozade
•150 mL (half a can) of non-diet fizzy drink
•200mL (small carton) of fruit juice
•4 large jelly babies.
Test your blood glucose after 10 minutes. If still less than 4 mmol/L,
or you still have symptoms, repeat the treatment. Follow with a starchy
snack like fruit or biscuits.
Recommendations for people with
diabetes who fast:
•Pre-Ramadan assessment – It’s important to see your GP or nurse
at least 4 weeks before Ramadan, to discuss your options.
Remember, your health status can change from year to year so it’s
important to discuss each year whether you should fast or not.
• Dehydration – Fasting for long periods, especially in hot and humid
climates, can lead to dehydration. Drink plenty of fluids before the fast
begins at sunrise (sahur) and at the end of the fast at sunset (iftar).
•Medicines – Your diabetes medicines might need to be adjusted
during the month of Ramadan depending on what medication you are
taking, the length of the fast, and how well controlled your diabetes
is. You should see your doctor or nurse to discuss this, ideally at your
pre-Ramadan assessment.
•Food – Sugary foods and drinks will cause high blood glucose levels.
Fried and high-fat foods will cause weight gain. Therefore, try to keep
to sensible portions of these foods when breaking your fast.
Points to remember for people with
diabetes who fast during Ramadan:
•Activity – During the fasting period, continue with light to moderate
activity, but always consult with your doctor should you wish to increase
your activity levels for any reason. Taraweeh (night prayer) can be
included as part of your activity programme.
•Smoking – As smoking is not permitted during Ramadan it’s a good
time for you to think about quitting. Speak to your doctor or nurse about
this. Many pharmacies offer free smoking cessation services that can
help you.
•Blood glucose monitoring – Talk to your doctor or nurse about
how frequently you should monitor your blood glucose levels during
Ramadan. If you feel unwell or have had your medication adjusted during
Ramadan then you should check your blood glucose levels. Checking
them is not considered to be breaking your fast. If you have doubts
about this, you can discuss them with your imam.
Changes to my diabetes medication
during Ramadan:
Medication
Dose
Frequency
Remember to discuss your medication with your doctor or nurse before fasting.
If you have to break your fast for any reason, continue your meals
as normal for that day. If you’re able to, you could make up the fast
at a later date or provide fidyah (paying for someone poor to be fed).
You should ask your imam about this.
Fasting and diabetes
As you know, Sharia law permits the sick to be excused from fasting during
Ramadan and offer fidyah instead.
Understandably, despite this provision some Muslims with type 2 diabetes
still wish to fast. They should discuss the decision with their doctor or
nurse to ensure they don’t damage their health and to agree a medication
schedule that works best for them during Ramadan.
Because fasting makes blood glucose levels fall, this may lead to an
episode of hypoglycaemia (low blood glucose, also known as ‘hypo’).
The earlier hypos are treated, the easier it is to correct them.
If members of your congregation with type 2 diabetes do decide to fast,
it is very important that they discuss their medication schedule with their
doctor or nurse and then take their medication as agreed throughout
Ramadan. If you would like more information on type 2 diabetes, please
visit www.diabetes.org.uk
www.diabetesalliance.co.uk
123,706.011
Date of preparation: April 2014
For your imam
To help your imam understand more about your condition and how
it is affected by Ramadan, tear off this sheet and give it to them to read.
What is type 2 diabetes?
Diabetes is a lifelong condition where the level of glucose in the blood
is too high.
Around 2.5 million people in the UK have type 2 diabetes, with South Asian
and black people at the most risk of developing it.
Tear off here
In people with type 2 diabetes, either a large gland in the digestive
system, called the pancreas, doesn’t produce enough insulin, or the
person’s body doesn’t respond to the insulin in the right way. This can
make their glucose level too high. The possible long-term effects of type
2 diabetes include heart disease, stroke, kidney failure, nerve damage,
blindness and amputation.
www.diabetesalliance.co.uk
123,612.011
Date of preparation: April 2014