NHS England » Keeping patients with diabetes healthy during Ramadan (2024)

NHS England » Keeping patients with diabetes healthy during Ramadan (1)Mohammed Satar, GP Partner in Yorkshire, and Leisa Batkin, Locality Facilitator at Leeds GP Confederation recently ran a series of ‘Diabetes and Safer Ramadan’ events. They explain how their events are helping people with diabetes to reduce the risks of becoming ill during Ramadan if they decide to fast, as well as highlighting the dangers of fasting for people with diabetes.

The Qur’an requires Muslims to fast during the month of Ramadan from sunrise to sunset. Whilst there are exceptions to this – one of them being that people who are ill or have medical conditions do not have to fast, including people with diabetes – ultimately, it is a personal choice whether or not to fast.

For the next few years, Ramadan in the UK is in the late spring months and the lengths of fasts are long. Long fasts put a person with diabetes at higher risk of hypoglycaemia and dehydration.

The inspiration behind the events

Leisa explained:

As well as wanting to work with hard to reach communities to support them to make more empowered decisions, we know that people with diabetes observing Ramadan benefit from counselling on how to manage fasting with their condition.

Mohammed continued:

If people are properly educated, there is less likelihood of hypos and people are more likely to break their fast should they become unwell. There is also some data to suggest that outcomes may improve all year round.

The risks associated with diabetes and fasting

  • If a patient has complications associated with diabetes, such as poor vision or heart or kidney disease, the risk of aggravating these is very high and the patient should seriously consider not fasting
  • For people with diabetes taking certain tablets and/or insulin, fasting carries the risk of hypoglycaemia. If the patient feels that you are having a hypo, they must break your fast and take some sugary fluids followed by starchy food, in accordance with scripture, as otherwise they will harm your body and may need medical attention
  • The patient may develop high blood glucose levels during a fast if you do not take prescribed medication or if you are less physically active than normal, which could lead to diabetic ketoacidosis (DKA) – a serious condition requiring hospital treatment.

The events: A resounding success

Mohammed said:

We has a great turnout from a broad range of healthcare professionals including Pharmacists, Practice Nurses, GPs, voluntary organisations, NHS Diabetes Prevention Programme colleagues, Leeds GP Confederation, Leeds City Council, Public Health colleagues and 30+ people with diabetes too.

NHS England » Keeping patients with diabetes healthy during Ramadan (2)

On marketing the events and encouraging attendance, Leisa added:

We promoted the events through word of mouth, GP engagement with patients, local news and radio stations, text messages to patients, social media, printed materials in council and primary care buildings and third sector engagement events.

Lessons learnt for future diabetes and Ramadan events

  • Get a local mosque involved to help promote the events
  • Use an interpreter to encourage real conversations in multiple languages
  • Share in the eating of food as that is when the best conversations happen
  • Choose a familiar venue within the community
  • Collaborate with health, public health and local authority colleagues and meet regularly
  • Any cooking should be culturally relevant (for example soup is not usually a staple of Pakistani diet)
  • Get in touch with your local CCG communications team who can support the events – ours had a photographer come along to help with marketing
  • Attend a diabetes and Ramadan event to learn about latest guidance i.e the South Asian Health Foundation annual event in London

Helpful resources

A number of resources and materials were shared at the events. You can download these via the following links:

For more information on the events and any of the above, contact mohammed.sattar@nhs.net or leisa.batkin@nhs.net.

NHS England » Keeping patients with diabetes healthy during Ramadan (2024)

FAQs

NHS England » Keeping patients with diabetes healthy during Ramadan? ›

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.

How do you manage diabetes during Ramadan? ›

The iftar and suhoor doses will need to be adjusted. If you have type 1 diabetes and you are on an insulin pump, generally the basal rates will need to be reduced by 20-40% in the last three to four hours of fasting. You should increase your basal rates by up to 30% after iftar.

Is insulin allowed in Ramadan? ›

Hence, taking any medication orally is not allowed during fasting. Please note that fasting is from dawn to dusk and therefore usual oral medications taken once or twice a day can be taken during Ramadan from dust to dawn. If hyperglycaemia prevails during the day, an insulin injection can be taken.

What is the average life expectancy of someone with type 2 diabetes? ›

Life expectancy is known as the number of years a person is expected to live. At age 50, life expectancy is 6 years shorter for people with type 2 diabetes than for people without diabetes. By meeting type 2 diabetes treatment goals, life expectancy can increase by 3 years, or for some, as much as 10 years.

Is metformin taken 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. Generally speaking metformin is safe to take whilst fasting.

How to maintain blood sugar while fasting? ›

Avoid foods that are high in sugar, such as candy or sugary drinks. Drinking enough water while fasting can prevent dehydration which can affect blood sugar levels. Monitor your blood sugar levels regularly while fasting.

What happens if someone with diabetes fasts? ›

A: People with type 1 diabetes are at greater risk when fasting compared to people with type 2 diabetes, because they are on insulin. The amount of insulin they take when fasting needs to be adjusted. If they don't cut back enough, they risk hypoglycemia, but if it is cut back too much, they can develop hyperglycemia.

What is a key consideration when managing diabetes during fasting? ›

Advice should cover fluid intake, diet, exercise, blood glucose monitoring, medication management and when to break their fast. A key factor in choice or adjustment of diabetes medication will be the avoidance of daytime hypoglycaemia during the fasting period.

Can you inject medication during Ramadan? ›

Intramuscular, subcutaneous or intravenous injection will not break the fast. Injection does not contain any food or drinks and therefore it cannot be considered as eating or drinking. However, injection that contains food will break the fast (Al-Syeikh Ahmad M.,2007).

Can a sugar patient keep fast? ›

Can you fast if you have diabetes? Yes in some circ*mstances, but it depends on your health. Ultimately, it is a personal choice whether or not to fast. However, if you do choose to fast, then you must consult your doctor or healthcare team, to make sure that you are able to look after yourself properly.

How to control diabetes with fasting? ›

If you have diabetes and are fasting, it is a good idea to include more slowly absorbed foods (that have a lower glycaemic index) just before you begin the fast. Choosing these types of foods will help to fill you up and keep your blood glucose levels more even during the course of the fast.

What should diabetics eat during Ramzan? ›

If you manage your diabetes with diet and exercise
  1. Divide your daily food into two meals, Sehri and Iftar.
  2. Eat more fibre rich foods which are digested slowly; include bran, cereals, whole wheat, grains and seeds, potatoes with skin, vegetables such as green beans, aubergines and almost all fruits.

Can I check my blood sugar during Ramadan? ›

Checking Blood Glucose. Checking your blood glucose through finger prick does not invalidate fasting state. So encourage patients to check blood glucose periodically. If blood sugar levels are low and patient experiencing signs/symptoms of hypoglycemia, it is advisable that fast is broken immediately.

What is the fasting goal for diabetics? ›

In terms of fasting glucose, recommended goals are set within a 70–130 mg/dl (3.9–7.2 mmol/l) range for the American Diabetes Association (17) and at <110 mg/dl (6.1 mmol/l) and 100 mg/dl (5.5 mmol/l) for the American College of Endocrinologists (18) and the International Diabetes Federation (19), respectively.

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