I have Diabetes. Can I fast during Ramadan?

Yes. You can, but you need to stick to the following to ensure safe fasting:

• should have good CBS control (80 – 190 mg/dL) months before Ramadan
• should have hypoglycaemic awareness (should feel when sugar level <70)
• should check CBS every day about 6 times or more during Ramadan
• If CBS <70, should break fasting immediately (eat 1 teaspoon of sugar followed by a snack.)
• Meet your doctor, get advice before and during Ramadan

At what time should I check CBS?

• Before pre-dawn meal (suhor)
• 2hrs after pre-dawn meal
• Midday (12 pm)
• 2hrs before finishing fasting
• Before sunset meal (iftar)
• 2hrs after sunset meal
• Whenever you get hypoglycaemic (low sugar) symptoms

Do I need to take insulin during fasting days?

Yes. It’s a must to take insulin in lower doses as the doctor directs.
If you do not take insulin, you will end up with life-threatening conditions (DKA).

How do you adjust the insulin dose for fasting days?

If you are on a multiple daily dose (MDI) (4 injections) regimen:

Lantus (basal) insulin:
Reduce 20% from usual dose
Start from the night before fasting
Ex: usual dose 10u -> Ramadan dose 8u

Pre meal insulin:
Dose is reduced by 25-50% for the dawn meal and the after-sunset meal.
Do not take mid-day insulin
Ex: 1u/potion usual dose 8u -> Ramadan dose 6u or 4u
If you take milk/snack to break fast, include that also in the carb counting

If you are on 2 injections (pre-mixed insulin)
You will need more dose adjustments as you are more prone to develop low sugar levels during fasting.
Take morning dose before sunset meal, and a short acting insulin dose at the time of pre-dawn meal.

Ex: if you are on morning 8u and evening 4u

• take short acting insulin (soluble Insulin) to cover pre-dawn meal -> soluble insulin 4u
• Take Premixed insulin (mixtard) 8u before the sunset meal

Can I eat any food /drink during Ramadan?

• Select food carefully to avoid sudden increase in sugar levels, excessive weight gain and abnormality in lipid levels
• Eat carbohydrates with low glycemic index
• include sour fruit, vegetables, and lean protein.
• Olive oil (MUFA/PUFA) should be used instead of saturated fat
• Limit sweets and fried foods
• Avoid sweetened drinks

What else should I know about eating?

• The pre-dawn meal (Suhor) should be as late as possible
• Accurate carbohydrate counting particularly at the pre-dawn (Suhor) and sunset (Iftar) meals
• Hydration should be maintained by drinking water and other non-sweetened drinks at regular intervals during non-fasting hours

Can I do exercise/ sports during Ramadan?

We encourage you to do exercise in fasting during Ramadan.
Avoid strenuous activities, especially closer to the sunset meal.