Manage diabetes during Ramadan

1. Should diabetic patients avoid fasting?
   
   

   

   The American Diabetes Association highlights that diabetic patients run a risk of medical complications during fasting.
   However, as fasting is a personal decision, diabetic patients should discuss their treatment plan with their physicians at least 1 to 2 months before ramadan begins.
   
   
2. How to manage your diabetes during Ramadan?
   
   

   At least 1 - 2 months before ramadan	Pre-ramadan medical assessment Speak to your physician for individualised advice so as to minimise the risk associated with fasting.
   During fasting, especially daytime	Monitor your blood sugar levels more frequently especially if you are on insulin therapy or multiple anti-diabetic medications. Test your blood sugar immediately if you experience hypoglycemic symptoms or are feeling unwell.
   During Iftar (sunset meal) or Suhur (pre-dawn meal)	Avoid eating too much carbohydrates and fat, especially during Iftar. Drink more water during non-fasting hours
   When exercising	Avoid excessive rigorous exercise especially before Iftar (sunset meal). Change your exercise timing to about two hours after Iftar.

3. What symptoms to look out for?
• Chest pain
• Confusion
• Dizziness
• Fruity odour on breath
• Heart palpitation
• Muscle cramps
• Nausea & vomiting 
• Weakness

4.  When you feel unwell or experience the symptoms above

• Break you fast
• Check your blood glucose immediately
• Seek medical advice immediately if:
  • blood glucose <3.3mmol/L (60mg/dL)
  • blood glucose <3.9mmol/L (70mg/dL) in first few hourse after starting of fast
  • blood glucose >16.7mmol/L (300mg/dL)
• Call 995 if you need an ambulance immediately
• Avoid fastng on sick days.

Updated July 2023