INTRODUCTION TO RAMADAN 1.1

• Ramadan (Sawm) is one of the five pillars of Islam.

• This year it will start on 18 June, it varies according

to the lunar calendar.

• For the next few years it will be during the Summer,

which means longer hours without food.

• Most people take two meals in the day.

Sehri (meal before dawn) and Iftaar (meal after sunset).

The Month of Ramadan in which the Quran was revealed,

a guidance for mankind and clear proofs for the guidance and

criterion between right and wrong.

(Surah Baqarah: Ayah 185)

WHO IS

EXEMPT?

WHO IS EXEMPT? 1.2

There are certain groups of people and circumstances

where you may be exempt from fasting. For example:

• children (under the age of puberty)

• elderly

• the sick

• those with learning difficulties

• those who are travelling

• pregnant, breastfeeding and menstruating women.

However, should any one of you be sick or on a journey, then

(he should fast) a number of other days (equal to the missed ones);

And as for those who fast (with difficulty) they have a choice either

to fast or to feed a poor person for every day.

(Surah Baqarah: Ayah 184)

WHAT IS DIABETES? 1.3

• Diabetes is a health condition where the amount of

glucose in your blood gets too high.

• This happens if your pancreas doesn’t make any insulin

or enough insulin to help the glucose enter your body’s

cells. Or the insulin doesn’t work properly.

• Insulin is the hormone produced by the pancreas that

allows glucose to enter the body’s cells, where it’s used

as fuel for energy so we can live our lives.

• Glucose come from digesting carbohydrate and is also

produced by the liver.

• If you have diabetes, your body cannot make proper

use of this fuel and it builds up in the blood which can

be dangerous.

1.3

• The body is unable to

produce the hormone

insulin, which we need

to break down the glucose

(energy) in what we eat

or drink.

• Unrelated to lifestyle

factors and is

not preventable.

• Usually diagnosed

when you are a child

or young adult.

• 10% of people

with diabetes.

• Develops when the body

cannot make enough insulin,

or when the insulin produced

does not work properly.

• Linked to lifestyle and can

be preventable.

• Starts gradually, usually

later in life, and because

the symptoms may not be

so obvious it might be years

before it is diagnosed.

• 90% of people with diabetes.

BLOOD GLUCOSE CONTROL 1.3

• It’s very important to have good blood glucose control if you have been diagnosed with diabetes.

• If your blood glucose levels are too high for too long, you can get extremely ill.

• Good glucose control helps reduce your risk of developing future complications such as:

– Blindness

– Heart disease

– Stroke

– Nerve damage

– Kidney disease.

1.4

ON THE BODY

Ramadan and Diabetes:

A guide for patients

www.mcb.org.uk

IMPACT OF FASTING

IMPACT OF FASTING 1.4

ON THE BODY

If you have a blood glucose meter it is important

that you check your blood glucose levels more often

during fasting.

O you who believe! fasting is prescribed for you, as it was

prescribed upon those before you in order that you may

attain taqwa.

(Surah Baqarah, Ayah 183).

For those who patiently persevere will truly

receive a reward without measure.

(Surah Zumar, Ayah 10)

POTENTIAL RISKS 1.5

WHEN FASTING

1 Hypoglycaemia (when glucose levels are too low)

• Shaking, sweating

• Blurred vision

• Tingling of the lips

• Irritability/anxiety

• Fast pulse/palpitations.

Not all people with diabetes will be at risk of hypos

– only those with insulin or using certain medication.

POTENTIAL RISKS 1.5

WHEN FASTING

2 Hyperglycaemia (When glucose levels are too high)

• Thirst

• Going to the toilet more often

• Headaches

• Extreme tiredness

• Ketones – pear drop smell on breath (mainly for people

with Type 1 and occasionally for people with Type 2).

POTENTIAL RISKS 1.5

WHEN FASTING

3 Dehydration

• Feel more thirsty

• Not going to the toilet as often

• Dry mouth, lips and skin.

Remember testing your blood glucose levels doesn’t

break your fast so if you have the facility to test your

blood glucose levels regularly please do so.

WHAT ARE MY OPTIONS? 1.6

• Visit your doctor two months prior to Ramadan.

• If you are advised by your doctor to not fast, then take

that advice.

• If you are unable to fast, speak to your local Imam.

• It may be a good idea to do a couple of days in the month

before Ramadan (Shabaan) to see if you are capable of

completing it without any complications.

• In certain areas there are education programmes available

to help you manage your diabetes during Ramadan.

I never saw the Messenger of Allah (saws) fast for an entire

month except in Ramadan and I never saw him fast more

than he did in Shabaan.

(Bukhari and Muslim)

HOW SHOULD I 1.7

MANAGE MY DIABETES?

• It is important to take your medication with your food and

during Ramadan a suitable medication plan needs to be

devised with your doctor or diabetes team.

• Without discussing it with your doctor you could be at risk

of hypoglycaemia (hypo) and hyperglycaemia (hyper).

• Rigorous exercise is not recommended as the risk of

hypos may be increased.

Make not your own hands contribute to your destruction.

(Surah Baqarah, Ayah 195)

FOOD CHOICES 1.8

• Healthy ways to open your fast would be slow-releasing

food such as porridge, chapatti, lentils, beans, basmati rice

or a handful of nuts.

• Foods high in saturated fats should be avoided i.e ghee,

samosas and pakoras.

• Healthy ways to break the fast include a handful of dates

and some water.

Actions are according to intentions, and a person will get

the reward according to his intention.

(Bukhari)

1.2

Eat of the good wholesome things.

(Surah Ta-Ha, Ayah 81)

TAKE-HOME MESSAGES 1.9

• Testing your blood glucose levels is important and it does not break the fast. If you have a blood testing meter, test your glucose levels regularly.

• Talk to your doctor or diabetes team before fasting.

• Look for signs of hyperglycaemia, hypoglycaemia and dehydration.

• Make sure someone you know is aware that you are fasting.

• Always carry your glucose tablets, glucose gel or a sugary drink in case of a hypo. This may need to be followed up with a snack like a piece of fruit, biscuit or half a sandwich.

• Finally, if you are ill it is important that you break your fast.

REFERENCES

Websites

• www.diabetes.org.uk

• www.mcb.org.uk

Studies

• Hui et al, Management of people with Diabetes wanting

to fast during Ramadan, 2010, BMJ

With thanks also to Imam Yunus Dudhwala Head of Chaplaincy & Bereavement Services,

Barts Health NHS Trust,

Newham University Hospital,

Glen Road, London E13 8SL.

HELP US MAKE RAMADAN SAFER

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FOR PEOPLE WITH DIABETES