Diaetes and Ramadan

Guidelines for people with diabetes

Fasting with diabetes can lead to complications that include:
* Low blood glucose (hypoglycaemia)
* High blood glucose (hyperglycaemia)
* Dehydration
* Diabetic ketoacidosis (DKA), in people with type 1 diabetes
It is therefore important that the decision about whether to fast is made on an individual basis in consultation with a healthcare provider, taking into account the severity of illness and the level of risk involved. 
Tips for a healthy Ramadan with diabetes
Know your risk before you decide to fast
As per the Holy Quran, there are groups of people who might make themselves ill by fasting. Based on medical and religious advice, it is recommended to visit your doctor 6-8 weeks before Ramadan to understand your risk category before deciding to fast. If your doctor advises not to fast, you will get the same Thawab (reward).
Check your blood glucose regularly
Blood glucose monitoring and insulin injections do not break the fast and are important. They are your window to know your blood glucose levels and manage your diabetes. Changes in eating habits during Ramadan may affect your blood glucose and therefore it is important check blood glucose levels regularly.
* People at very high risk (even if not fasting) should check blood glucose levels 3-4 times a day
* People at moderate or low risk should check blood glucose levels 1-2 times a day

When to break the fast?
All people with diabetes should break the fast if:
* Blood glucose is lower than 70 mg/dl (3.9 m mol/L). Re-check within one hour if blood glucose is in the range 70-90 mg/dl (50- 3.9 m mol/L)
* Blood glucose is higher than 300 mg/dl (16.6 m mol/L)*
* Symptoms of hypoglycemia, hyperglycemia, dehydration or acute illness occur
Exercising during Ramadan
Perform regular light-to moderate exercise. Rigorous exercise is not recommended during fasting because of the increased risk of low blood glucose and/or dehydration. Physical exertions involved in Tarawih prayers, such as bowing, kneeling and rising, should be considered part of your daily exercise activities.