UAE experts explain how diabetics can fast safely during Ramadan

Fasting can offer a beneficial reset if planned properly but diabetics should take extra care to protect their health

A healthy diet based on more vegetables and fluids is advised for diabetics breaking their fast during Ramadan. EPA

Doctors have urged diabetics observing Ramadan to be vigilant while fasting to maintain good health throughout the holy month.

Regulating blood sugar levels is a daily challenge for those with the condition, but there is need to be especially mindful when food is restricted during daylight hours to avoid a dangerous hypoglycaemic attack.

Severe hypoglycaemia — an abnormally low level of blood glucose — can lead to confusion or seizure. In some cases hospital treatment is required, so blood sugar levels should be checked regularly throughout fasting periods.

Typically, blood sugars dropping below 70 milligrams per decilitre can be harmful, and when it falls below 54 immediate action should be taken, doctors said.

“It is highly recommended for diabetic patients to have a physical check-up by their doctor prior to Ramadan to evaluate whether they are capable of fasting, or if it is risky,” said Dr Ghassan Aldadah, a consultant at Saudi German Hospital, Ajman.

“They should set up a clear, detailed healthy diet, focused on more vegetables and fluids while reducing cholesterol-rich food.”

Heavy sweating, extreme fatigue, rapid heart rate, severe thirst and dizziness are all precursors to a potential problem in need of immediate attention.

The UAE has some of the highest rates of diabetes in the region, with about 990,000 reported to have the condition by the International Diabetes Federation in 2021, with that number set to rise to almost 1.2 million by 2030.

Ramadan can be a busy time for health professionals as clinics respond to illness related to fasting and chronic conditions such as diabetes, hypertension and cardiovascular disease.

Despite the potential pitfalls, doctors say fasting can be done safely.

“Those who have low risk and control their diabetes at baseline do not need to adjust their medication or change much before Ramadan,” said Dr Bashar Sahar, of Saudi German Hospital, Dubai.

“Anyone with diabetes should make sure they have a glucose meter and know how to use it.

“Their meal-timing and eating patterns will be different during Ramadan, so it is important to know what actions to take if they have high or low blood sugars during a fast.”

The human body enters a fasting state, usually eight hours after the last meal. It will initially use stored sources of glucose and as the fast develops, breaking down body fat to use as energy.

Tips for fasting safely

To stay healthy, doctors advised those with diabetes to add foods absorbed more slowly with a lower glycaemic index to enable them to fast safely and avoid complications.

Foods with a low GI include lentils, whole wheat bread, apples, oranges, carrots, peas — even strawberry jam and chocolate are absorbed more slowly than many other foods, although portion size remains critical to balance glucose levels.

If fasting and a glucose monitor shows a sharp rise in blood sugars, it is important to break the fast and drink sugar-free fluids to reduce dehydration and diabetic ketoacidosis, that would likely require hospital treatment.

Although fasting has proven health benefits such as weight loss, better blood sugar control, decreased inflammation and improved heart health, it is not always suitable, and not only for those managing a chronic health condition.

Children, pregnant women and people with certain illnesses are not advised to fast during Ramadan.

“If you are acutely unwell with an illness like influenza, a cold, gastroenteritis, or any condition that requires you to take medicine or fluids, it is encouraged you do not fast on those days,” said Dr Krithika​ Rani, a family doctor at the Burjuman Prime Medical Centre.

Pregnant women in particular have been advised to consult with their doctor before Ramadan to ensure that fasting is safe.

“Pregnancy can be physically and emotionally demanding so it is important to get enough rest and avoid strenuous physical activities,” said Dr Saba Khalid at the Prime Medical Centre.

“If you experience any discomfort or health issues during fasting, it is important to break the fast and seek medical attention.”