As the holy month of Ramadan approaches, millions of Muslims across Bangladesh prepare for a time of spiritual reflection, discipline and fasting. However, for people living with diabetes, the thought of fasting from dawn to dusk often brings anxiety along with faith.
Diabetes is a chronic condition in which blood sugar (glucose) levels remain too high. This happens either because the body does not produce enough insulin or cannot use it effectively. Without proper control, the excess glucose in the bloodstream can lead to serious health complications affecting the heart, kidneys, nerves and eyes.
Fasting changes eating patterns, sleeping schedules and medication timings, all of which directly affect blood sugar levels. Without proper guidance, people with diabetes may face dangerous drops in blood sugar (hypoglycaemia), sudden spikes (hyperglycaemia), dehydration or, in severe cases, diabetic ketoacidosis.
Yet endocrinologists say that a diagnosis of diabetes does not automatically mean a person cannot fast.
This message was reinforced at a recent press conference organised by the Association of Clinical Endocrinologists and Diabetologists of Bangladesh (ACEDB) in Dhaka. Specialists noted that with careful planning, medical supervision and disciplined habits, many people with diabetes can observe Ramadan safely. The foundation of safe fasting lies in preparation.
Consult a doctor early
As a diabetic, your preparation for fasting starts way before the month of Ramadan. Medical consultation with a doctor at least four weeks before Ramadan is very important. Doctors can assess individual risk, adjust medication or insulin doses and determine whether fasting is safe. Each patient’s condition is different, and fasting plans must be personalised.
Monitor blood sugar regularly
Regular blood glucose monitoring is essential during Ramadan. Importantly, checking blood sugar does not break the fast. Levels should be checked before Seheri, during fasting hours if symptoms appear, and after Iftar. If blood sugar falls too low or rises to a dangerous level, the fast must be broken immediately. Protecting health comes first.
Never skip Sehri
The pre-dawn meal, Sehri, is not optional for someone with diabetes. Skipping it significantly increases the risk of low blood sugar during the day. Suhoor should include complex carbohydrates (such as whole grains), fibre, protein and healthy fats. These provide steady energy and help stabilise glucose levels throughout the fasting hours.
Break the fast wisely
The patient must eat their Iftar sensibly and moderately. It should begin with water and a small portion of food, such as dates or fruit. Overeating should be avoided. Foods like fried foods, sweets and sugary drinks should be limited to prevent sudden blood sugar spikes. Moderation, not indulgence, is the key to safe fasting.
Stay hydrated
Dehydration can be a serious risk, particularly in Bangladesh’s warm climate. Adequate water intake between Iftar and Suhoor is crucial. However, excessive tea, coffee and soft drinks should be avoided as they may worsen dehydration.
Maintain safe physical activity
Light to moderate physical activity can continue during Ramadan. However, strenuous exercise during fasting hours should be avoided. Gentle walks after Iftar are generally safer and can help maintain glucose control.
Know when not to fast
Fasting is not recommended for people with uncontrolled diabetes, frequent hypoglycaemic episodes, kidney disease and for pregnant women with diabetes. In such cases, fasting may pose serious health risks.
Religious perspective
Islam clearly provides exemption from fasting for those who are ill. Preserving health is a priority in Islamic teachings. Breaking the fast when blood sugar becomes unsafe is not a failure of faith; it is a responsible choice.
As Ramadan draws near, medical experts remind the community that faith and health do not stand in opposition. With awareness, planning and informed decisions, many people with diabetes can observe the fast safely, honouring both their spiritual devotion and physical well-being.
