This year Ramadan and Easter fall earlier than 2022, so we are looking at religious fasting and its impact on the management of diabetes during periods of abstinence and fasting. Two major religions, Islam and Christianity, have periods of fasting around this time of year (many other religions also have fast periods). Many people will have fasted before, so this may be just a reminder but for those of you who have not, we look at fasting practices and general issues around diabetes and fasting and hope we provide some helpful tips for staying safe and well during your fast.
Islam – Ramadan
Ramadan is based on the ninth month of the lunar calendar and moves forward each year by about 11 days which means the length of fasting is greater in certain years than others.
This year the fast of Ramadan will commence at sunset on 22nd March and will last until 21st April. During Ramadan it is expected that Muslims who participate will abstain from food, water, beverages, smoking, oral drugs and sexual intercourse from sunrise to sunset.
Christianity – Lent/Easter
Easter Sunday is celebrated on the first Sunday following the full Moon that occurs on or just after the spring equinox. Although not followed by all Christian denominations, Lent lasts for 40 days, concluding on Maundy Thursday, immediately prior to Easter Sunday. This year, Lent is from 22nd February to 6th April and Easter Sunday is on 9th April. During Lent, certain days are regarded as fast days, which again has implications for people with diabetes.
Diabetes and fasting
People with diabetes of either faith may be exempted from fasting but the majority of people with diabetes do fast so run increased risks of health adverse effects, such as hypoglycaemia, hyperglycaemia, diabetic ketoacidosis and dehydration. Most of these are as a result of a reduction of food and fluid intake and the timing of meals.
If you have diabetes fasting can cause complications in managing the condition, some, arguably, more serious than others. The best first step is to speak to your doctor or diabetes nurse to discuss the potential risks and problems associated with fasting. This will help you to formulate a plan to manage the period of your fast. Things you may want to think about and discuss could include:
- Complications of diabetes such as poor vision or heart or kidney disease, can be aggravated by fasting and you may want to consider whether to fast or not.
- If you take insulin and/or certain tablets, you may need to think about changing the amount and timing of your insulin dose to control blood sugar levels. You may also need to change the type of insulin you are using, for example, pre-mixed insulins are not recommended during fasting.
Research has shown that both education about the effects of fasting and relevant advice can dramatically reduce the likelihood of problems occurring, both low and high blood sugar levels. High blood glucose levels can develop during a fast if you do not take prescribed medication or if you are less physically active than normal, which, in turn, could lead to diabetic ketoacidosis (DKA) – a serious condition requiring hospital treatment.
If you are still happy to proceed with your fast then there are some simple, common-sense tips ad tricks to help manage your diabetes:
- Before starting the fast, you should eat foods containing slowly absorbed carbohydrates, such as rice, dhal, potatoes and pasta, along with fruit and vegetables.
- You should check your blood glucose levels more often than you normally would.
- When you break the fast, have only small quantities food and avoid eating only sweet or fatty foods.
- Try to eat just before the break of dawn, when you commence the next day’s fast.
- At the end of fasting, you should drink plenty of sugar-free and decaffeinated fluids to avoid being dehydrated.
Above all – Stay safe and well!!!