Diabetes and Ramadan (2024)

This page has information for people living with diabetes who are thinking about fasting for Ramadan.

Ramadan in 2022 will run from on or around Saturday 2 April for 29 or 30 days, ending with Eid al-Fitr, a religious holiday celebrated by Muslims worldwide.

Download our factsheets about diabetes and Ramadan, which includefasting and managing your diabetes during this time, which have been developed in partnership with the Muslim Council of Britain’s Diabetes Advisory Group.

These are available in English (PDF, 803KB), Arabic (PDF, 125KB), Bengali (PDF, 143KB)and Urdu (PDF, 91KB) to share with friends or family who are not online.

You can skip to advice on:

  • Choosing whether to fast, including what risks to be aware of
  • Planning to fast safely
  • Testing your blood sugars during Ramadan
  • Healthier food and drink during Ramadan
  • Eid
  • Alternatives to fasting
  • Yourstories
  • Further support and advice

Get the latest information on diabetes and Ramadan

In February 2022 we held a webinar on diabetes and Ramadan offering information and support for anyone preparing for and participating in the holy month.

As well as hearing from people with lived experience of diabetes and Ramadan, the event also included information from Moulana Azizur Rahman and health expert Dr Waqas Tahir, from Act as One and West Yorkshire Health and Care Partnership.

The Qur'an requires Muslims to fast during the month of Ramadan from sunrise to sunset.

However, there are exceptions to this. One of them is that people who are ill or have medical conditions do not have to fast. This can include people living with diabetes.

“I know that Ramadan is a very important time of year for Muslims around the world. It is important to ensure that people who are living with diabetes only fast after discussing it first with their diabetes team. Fasting can be dangerous if you have diabetes as it can cause health problems. I recommend taking a few minutes to read Diabetes UK's information before you make a final decision. And if you know someone who can’t access this page, then please find a way to share this information with them.”

- Professor Wasim Hanif, Professor of Diabetes and Endocrinology, Consultant Physician, and Clinical Director in Diabetes at University Hospital Birmingham. A member of our board of trustees.

Diabetes and Ramadan (1)

Before deciding to fast, it is important to check in with your healthcare team to see how you are currently managing your diabetes. This can help you to understand how fasting could be a risk to your health, how to reduce this risk or whether the risk to your health is too high.

Take this opportunity to talk about what is or isn’t working well for you and your diabetes. If you find your diabetes is not quite on track before the fast, it would not be a safe option to fast this year.

Knowing this can help you make a plan on how to improve your diabetes and health over the next year. This can help you feel confident that you are working towards improving your health if you revisit the decision to fast the following year.

We would also suggest that you speak to an Imam to gain further advice about the alternatives to fasting if you are advised not to fast for health reasons. If you are an Imam and would like more information on advising people with diabetes during Ramadan, download our short guidance document(PDF, 65KB).

Ultimately, it is a personal choice whether or not to fast. However, if you do choose to fast, it is important to be prepared before Ramadan by speaking with your healthcare team so you have a plan for keeping safe and healthy.

Failing to do so is in itself contrary to the Qur'an, which clearly states that you must not act in a way that harms your body (Al Baqarah Verse: 195).

People can also be exempt from fasting if they:

  • are children (under the age of puberty)
  • are elderly
  • are sick or have a certain health condition
  • have learning difficulties
  • are travelling
  • are pregnant, breastfeeding or menstruating.

If you’re showing any symptoms of coronavirus (Covid-19), it would be advisable not to fast. If you're fasting during Ramadan, getting the coronavirus vaccine does not break your fast.

Risks of fasting

It is important to discuss with your healthcare team how living with diabetes and following Ramadan could put your health at risk. Understanding your risk will depend on:

  • The type of diabetes you are living with
  • If you are currently keeping your average blood sugar level in a healthy range (HbA1c level less than 58 mmol/mol)
  • The type of medication you use to manage your diabetes
  • If you take medications that put you at risk of hypoglycaemia, such as sulphonylureas and insulin
  • If you're living with diabetes complications such as poor vision, nerve damage, heart or kidney disease. There is a high risk that fasting could make these health conditions worse.

For example, people living with type 2 diabetes who manage with diet and lifestyle only, or who take one diabetes medication will have a lower risk during the fast if they are already keeping their average blood sugar level (HbA1c) in a healthy range.

Making a plan to fast safely

When discussing the risk of fasting with your healthcare team it important to agree a plan so you can fast safely.

This may include:

  • Checking your blood sugar levels more often than you normally would and making sure you have enough test strips to do this.
  • What to do if your blood sugar is too low or too high, or if you become unwell (Sick Day rules).
  • Adjustments to your diabetes tablets, you may need a different type, or dose and need to know the best time to take them.
  • Adjustments to your insulin. You won’t need as much insulin before the start of the fast. Also, the type of insulin may need changing from your usual type. Reminder, pre-mixed insulin is not recommended during fasting.

Testing blood sugars during the fast

If you take certain tablets or insulin, fasting carries the risk of low blood sugars (hypoglycaemia).

This means it’s important for you to know the signs and symptoms of low blood sugar and to test your blood sugars more often during the fast.

If your blood sugars drop below 4 mmol/l you must break your fast and take some sugary fluids followed by starchy food as otherwise you will harm your body and may need medical attention. It’s a good idea to carry hypo treatments with you and a bottle of water during the fasting period.

You may develop high blood sugar levels during a fast if you miss your usual prescribed medication, if you have larger portions of starchy or sugary foods or if you are less physically active than normal. High blood sugars can increase your risk of dehydration which can make you feel dizzy and tired.

If your blood sugar is 16.6 mmol/l or more you must break the fast and seek medical advice. Without medical advice this could lead to diabetic ketoacidosis (DKA) – a serious condition requiring hospital treatment.

If you’re not able to get hold of your GP or diabetes team, it would be advisable not to fast, especially if you’re not sure of what to do with your diabetes medications. And if you need urgent medical help, you can use the NHS 111 online service.

Healthier food and drink choices during Ramadan

At suhoor (predawn meal)

It’s important not to skip the suhoor meal, which is just before dawn. High fibre starchy foods like high fibre cereals or oats, buckwheat, bulgur wheat or brown or wild rice are more slowly absorbed and have a low glycaemic index. These will help your blood sugar levels keep in a safe range whilst you’re fasting.

Lentils (dhal) chickpeas and beans are good sources of protein and are also high in fibre. Pair them with fruit and vegetables as this can help prevent constipation and keep your heart healthy.

Before starting the day’s fast you should drink plenty of sugar-free and decaffeinated fluids to avoid being dehydrated during the day.

At iftar meal (breaking of fast)

Traditionally the fast may be broken with dates, these are high in fibre but are rich source of carbohydrate. Two large dates (30g without stones) can provide around 20g of carbohydrate, which is about the same as a medium slice of bread. Try to limit the number of dates to one to open the fast or open the fast with a glass of water.

Try to rehydrate with sugar free fluids – water is the best option. Avoid sugary fizzy drinks or fruit juices as these will raise your blood sugar and make you feel thirstier.

Milk drinks such as lassi or laban are a good source of protein and calcium, but unsweetened versions are the healthier option.

It can be tempting to snack on sweet treats, especially if family or friends are sharing them. Treats such as baklava, barfi or rasmali can be high in fat and sugar. Only a small amount can make quite an impact on pushing up your blood sugars.

Try to only have fried and oily foods in moderation as eating them too frequently could lead to unintentional weight gain through Ramadan. These foods can also affect your heart health as they tend to be higher in saturated fats and salt which could increase your blood cholesterol and blood pressure above healthy levels.

Eid al-Fitr and the end of fasting

Eid is a major occasion and celebrations involve lots of food, which can be a challenge for people with diabetes. But having diabetes doesn’t mean you can't eat traditional festive foods. Check out our Learning Zone for simple food hacks to make traditional recipes healthier.

We have lots of great tips for healthier ways of celebrating during Eid. Learn more about making healthy swaps during Eid.

Dr Zafar Iqbal is a Consultant in Sports and Exercise Medicine and currently the Head of Sports Medicine at Crystal Palace FC. He's previously held the same position at Liverpool FC and worked as First Team Doctor at Tottenham Hotspur FC.

"Ramadan is a special time for the Muslim community, especially as we continue to face these troubling times. However, even though it seems the endDiabetes and Ramadan (2) of the pandemic is in sight, it remains vital that everyone does their best to stay fighting fit - particularly for those with diabetes who are at increased risk of poorer outcomes.

So if you do choose to fast, I encourage you to follow all advice. This will make living with diabetes during Ramadan that little bit safer"

Alternatives to fasting

If you’re not able to fast or choose not to, you can still observe and gain the benefits of Ramadan by offering charity or providing food to the poor. Speak to your local Imam for more information about this.

Abdul, who has type 2 diabetes, explains why he chooses not to fast during Ramadan and suggests alternatives.

Your stories

Muhammed's story: looking after my diabetes during Ramadan

A Muslim who observes Ramadan, Muhammed says he hasn’t always known how to manage his condition during the holy month, and says support from his healthcare team and employers has made a huge difference to his understanding of diabetes over time.

“Experience and the right support have made it safer and easier for me to fast during Ramadan. I always have the intention to fast during the holy month but I also know that I need to listen to my body and what it needs"

Shukrat's story: managing diabetes during Ramadan

Learning and understanding more about her relationship with type 1 diabetes and how it affects her has helped Shukrat during Ramadan.

"I understand that staying safe and well is the most important thing as I need to keep up with the other acts of worship in the holy month.”

Further advice and guidance

Call the Diabetes UK Helpline on 0345 123 2399. If you wish to speak in another language, this can easily be arranged.

The Muslim Council of Britain has the latest guidelines and advice for Muslims fasting during the month of Ramadan to help them make the most of the blessed month. This information isalso useful for the friends, neighbours and colleagues of Muslims.

For healthcare professionals, there is guidance on the management of type 1 and type 2 diabetes during Ramadan from the South Asian Health Foundation.

Diabetes and Ramadan (2024)


Can diabetics fast in Ramadan? ›

The Qur'an requires Muslims to fast during the month of Ramadan from sunrise to sunset. However, there are exceptions to this. One of them is that people who are ill or have medical conditions do not have to fast. This can include people living with diabetes.

How does Ramadan affect diabetes? ›

The main concern for diabetes management during Ramadan is hypoglycaemia. Fasting can disrupt normal glucose homeostasis and lead to serious consequences. Patients who choose to fast should be warned of these complications.

Is fasting good for diabetic person? ›

The American Diabetes Association doesn't recommend fasting as a technique for diabetes management. The association says lifestyle changes, including medical nutrition therapy and more physical activity, as the cornerstones for weight loss and good diabetes control.

Can fasting worsen diabetes? ›

Summary: Fasting every other day to lose weight impairs the action of sugar-regulating hormone, insulin, which may increase diabetes risk. These findings suggest that fasting-based diets may be associated with long-term health risks and careful consideration should be made before starting such weight loss programs.

What can a diabetic eat in Ramadan? ›

It is advisable to have the evening meal or dinner as early as possible at Iftar. This should comprise of whole wheat flour chapattis, vegetables and a meat dish. Salads should be taken to increase the fibre intake.

What Islam says about diabetes? ›

Muslims who are diabetic face significant challenges managing their diabetes as fasting requires abstention from all food, fluids, oral medications, and IV fluids (medicinal and nutritional) during daylight hours. Muslims may resist blood draws at this time in order to minimize fluid loss while fasting.

How do you take metformin during Ramadan? ›

Ramadan and Medication

It is recommended that two thirds of the dose of metformin should be taken at the sunset meal and one third of the dose should be taken at the predawn meal. 17 The lunchtime dose should be omitted.

Does fasting increase blood sugar in diabetics? ›

Scientists know that insulin resistance improves with calorie restriction. After a period of fasting, insulin sensitivity increases, and insulin levels decrease. These changes result in improved blood sugar levels both during fasting and shortly after eating.

Can you take insulin during Ramadan? ›

It is important to highlight that having subcutaneous insulin or intravenous fluids does not affect Ramadan fasting at all. Even intravenous glucose can be given to treat hypoglycaemia without invalidating the fast.

How many hours is considered fasting for a diabetic? ›

To prepare for a fasting glucose test, you should have nothing to eat or drink (except water) for 8 to 12 hours. Your healthcare provider will tell you how long to fast.

Can you take metformin while fasting? ›

If you are currently taking metformin to control your glucose levels, research shows it is safe to continue taking the medication when you start intermittent fasting. However, you shouldn't take the drug if you fast for an entire day as it could increase the risk of hypoglycemia.

Why is my blood sugar high after fasting for 16 hours? ›

Answer:This is a normal process. When you fast, insulin levels start to drop and this triggers a surge of counter-regulatory hormones, including noradrenalin and growth hormone. This is normal, and meant to pull some of the stored sugar from the liver into the blood.

How do you take diabetic medicine during Ramadan? ›

Type 2 diabetes

Metformin carries a low risk of hypoglcaemia and can be continued during the fasting period. If the dosage is three times daily then one-third should be given with the pre-fast meal (Suhur), and two-thirds at post-sunset meal (Iftar).

What can diabetics eat unlimited? ›

You can view the entire list here.
  • Carbonated water.
  • 1 Tbsp. unsweetened cocoa powder.
  • Coffee or tea.
  • 1 cup raw cabbage.
  • Hard, sugar-free candy.
  • 1 cup raw cucumber.
  • 2 Tbsp. whipped topping.
  • 1 cup raw salad greens and lettuce.
17 Nov 2022

What can a diabetic eat in Sehri? ›

The Sehri should include more proteins and less carbohydrate with lots of fruits, whole grain bread, whole grain low sugar cereals, beans and lentils. "Combine the pre-dawn food with proteins like eggs or dal which gradually releases energy through the day.

Can I check blood sugar during Ramadan? ›

If you are diabetic and you choose to fast during Ramadan, it is recommended you check your blood sugar levels frequently throughout the day; this is especially critical for patients who require insulin. It is recommended to check blood sugar levels at least four times a day: Between 10:00 am and 11:00 am.

What is forbidden in diabetes? ›

Your main goals should include staying away from unhealthy fats, liquid sugars, processed grains, and other foods that contain refined carbs. Avoiding foods that increase your blood sugar levels and drive insulin resistance can help keep you healthy and reduce your risk of future diabetes complications.

How does fasting affect diabetes 2? ›

Some work on people with diabetes has found that intermittent fasting may increase insulin sensitivity and also reduce insulin levels in the blood. This is a big deal. “Essentially, fasting is doing what we prescribe diabetes medications to do, which is to improve insulin sensitivity,” Horne says.

Does metformin affect fasting blood sugar? ›

Metformin caused a progressive decline in fasting blood glucose (from a mean of 84.9 to 75.1 mg%) and a reduction in fasting insulin levels (from 31.3 to 19.3 microU/mL). In contrast, fasting glucose levels in the placebo group rose slightly from 77.2 to 82.3 mg%, and fasting insulin levels did not change.

Can you take prescriptions during Ramadan? ›

During Ramadan, taking medicine orally (by mouth) is considered to be breaking the fast. If you're taking regular medicine or nutritional supplements and want to fast, speak to your doctor about your options before you start.

How can I control my fasting diabetes? ›

14 Easy Ways to Lower Blood Sugar Levels Naturally
  1. Exercise regularly. ...
  2. Manage your carb intake. ...
  3. Eat more fiber. ...
  4. Drink water and stay hydrated. ...
  5. Implement portion control. ...
  6. Choose foods with a low glycemic index. ...
  7. Try to manage your stress levels. ...
  8. Monitor your blood sugar levels.
30 Nov 2021

Why is my blood sugar still high after fasting? ›

High fasting blood sugar levels suggest that the body cannot lower blood sugar levels. The reason for this may be insulin resistance or inadequate insulin production, or in some cases, both. Recognising the signs and symptoms of hyperglycemia (high blood sugar) can help you manage your diabetes.

Why is my blood sugar so high when I'm not eating any carbs? ›

So people reduce their carb intake, go on a low carbohydrate diet, and focus on eating healthy fats and (in many cases) too much protein. But what this solution crucially fails to address is insulin resistance, which is the true cause of those high blood glucose numbers.

Does fasting lower blood sugar? ›

After intermittent fasting diet intervention, in terms of glucose metabolism, fasting blood glucose reduced by 0.15 mmol/L (95% CI: −0.23; −0.06), glycosylated hemoglobin reduced by 0.08 (95% CIs: −0.25; −0.10), insulin plasma levels reduced by 13.25 uUI (95% CIs: −16.69; −9.82), and HOMA-IR decreased by 0.31 on an ...

When should you not take metformin? ›

However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving metformin. This medicine is not recommended in patients 80 years of age and older who have kidney problems.

What is the best time to take metformin? ›

It's best to take metformin tablets with, or just after, your evening meal to reduce the chance of getting side effects. Swallow your metformin tablets whole with a drink of water. Do not chew them.

Does fasting help insulin resistance? ›

The primary physical benefit of intermittent fasting is improvement of metabolic health by lowering insulin resistance. While its effect on insulin levels can promote weight loss – what many people strive for – it can have many other powerful benefits for the body.

How can I stabilize my blood sugar overnight? ›

Try one the following healthful snacks before bed to help manage blood sugar levels and satisfy nighttime hunger:
  1. A handful of nuts. ...
  2. A hard-boiled egg. ...
  3. Low-fat cheese and whole-wheat crackers. ...
  4. Baby carrots, cherry tomatoes, or cucumber slices. ...
  5. Celery sticks with hummus. ...
  6. Air-popped popcorn. ...
  7. Roasted chickpeas.

What drink lowers blood sugar? ›

Green tea. Like coffee, green tea is packed with polyphenols, and 3 drinking it can lower your risk of type 2 diabetes3 . (However, you need to sip quite a bit of it to reap these benefits—about 6 cups a day, research suggests.) If you're looking for green tea with the highest number of polyphenols, opt for matcha.

Why is my fasting blood sugar high but not after eating? ›

This means that your blood sugar may be high in the morning, even before you eat anything. A few things can cause this surge in blood sugar, including: hormone release early in the morning that increases insulin resistance. insufficient insulin or medication left in your body from the night before.

Who Cannot fast in Ramadan? ›

As one of the five pillars, or duties, of Islam, fasting during the month of Ramadan is mandatory for all healthy adult Muslims. Children who have not reached puberty, the elderly, those who are physically or mentally incapable of fasting, pregnant women, breastfeeding mothers and travelers are exempt.

How many hours is fasting for a diabetic? ›

How do I prepare for a fasting blood sugar test? To prepare for a fasting glucose test, you should have nothing to eat or drink (except water) for 8 to 12 hours. Your healthcare provider will tell you how long to fast.

What makes your Ramadan fast invalid? ›

Eating and Drinking

Once a person intentionally eats or drinks anything during the day in the month of Ramadan, then his fast becomes null and void. This fundamentally involves getting food or water via the nose into the stomach.

What happens if you skip a day of Ramadan? ›

Kaffara (expiation) provides an opportunity to recompense for individuals who deliberately miss or break a fast during Ramadan without a valid reason. In the Hanafi school, if a person misses a day of fasting unnecessarily, he or she should either fast for 60 consecutive days or feed 60 poor people.

What is the punishment for not fasting in Ramadan? ›

If you deliberately break a fast without a valid reason, during the month of Ramadan or for breaking a promise/oath, you must paid Kaffarah. Both require a penalty to be paid. The amount paid for each missed fast is the equivalent of feeding 60 people.

Can fasting raise your blood sugar? ›

When fasting the hormone glucagon is stimulated and this increases plasma glucose levels in the body. If a patient doesn't have diabetes, their body will produce insulin to rebalance the increased glucose levels.

Does fasting for 12 hours increase blood sugar? ›

Scientists know that insulin resistance improves with calorie restriction. After a period of fasting, insulin sensitivity increases, and insulin levels decrease. These changes result in improved blood sugar levels both during fasting and shortly after eating.

Top Articles
Latest Posts
Article information

Author: Frankie Dare

Last Updated:

Views: 6193

Rating: 4.2 / 5 (73 voted)

Reviews: 80% of readers found this page helpful

Author information

Name: Frankie Dare

Birthday: 2000-01-27

Address: Suite 313 45115 Caridad Freeway, Port Barabaraville, MS 66713

Phone: +3769542039359

Job: Sales Manager

Hobby: Baton twirling, Stand-up comedy, Leather crafting, Rugby, tabletop games, Jigsaw puzzles, Air sports

Introduction: My name is Frankie Dare, I am a funny, beautiful, proud, fair, pleasant, cheerful, enthusiastic person who loves writing and wants to share my knowledge and understanding with you.