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Ramadan 2021

This year Ramadan will start on 12th April and continue until 12th May. During this month it is expected that Muslims who participate will abstain from food, water, beverages, smoking, oral drugs and sexual intercourse from sunrise to sunset.

Fasting has special consequences for people with diabetes, especially those taking insulin. People with diabetes may be exempted from fasting but the majority do fast so run increased risks of adverse health effects, such as hypoglycaemia, hyperglycaemia, diabetic ketoacidosis and dehydration, most of which are as a result of a reduction of food and fluid intake and the timing of meals.

People have to rely on expert advice from doctors and their personal experiences as there are no evidence-based guidelines for fasting.

Recommendations
What studies have been done suggest that people with Type 1 and Type 2 diabetes should more actively carry out blood glucose monitoring, consider any changes in insulin/drug dosage and timing and have dietary counselling/education. One study has shown that people with Type 2 who did not have education about fasting were 4 times more likely to have hypos, therefore, it is recommended that those who do not normally carry out self-monitoring of blood glucose should be provided with meters. (Diab. Med. February 2016)

The findings of this and other studies suggest that people with both types of diabetes should have an assessment with their diabetes team 1 to 2 months before Ramadan. This should include drug/insulin adjustments, exercise and awareness of the risks of hypo- and hyperglycaemia. If they are ill during fasting, then they should seek advice from their diabetes team.