Ramadan in 2021 will run from April 12 to May 11, ending with Eid al-Fitr, a religious holiday celebrated by Muslims worldwide.
This page has information for people living with diabetes who are thinking about fasting. It gives tips on reducing the risks of becoming ill if you decide to fast and and when it's advisable not to fast. We also have factsheets in different languages.
Fasting during Ramadan
The Qur'an requires Muslims to fast during the month of Ramadan from sunrise to sunset.
However, there are exceptions to this. One of them is that people who are ill or have medical conditions do not have to fast. This includes people with diabetes. To find out more about this, you can speak to your Imam. If you’re showing any symptom of coronavirus (Covid-19), it would be advisable not to fast.
“I know that Ramadan is a very important time of year for Muslims around the world. This holy month will be very different this year due to the Coronavirus outbreak. It is more important than ever therefore 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. And if you know someone who can’t access this page, then please find a way to share this information with them.”
- Professor Wasim Hanif, Professor of Diabetes and Endocrinology, Consultant Physician, and Clinical Director in Diabetes at University Hospital Birmingham. A member of our board of trustees.
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 before Ramadan, to make sure that you are able to look after yourself properly. Failing to do so is in itself contrary to the Qur'an, which clearly states that you must not act in a way that harms your body (Al Baqarah Verse: 195).
If you’re not able to get hold of your GP or diabetes team, it would be advisable not to fast especially if you’re not sure of what to do with your diabetes medications. And if you require urgent medical help you can use the NHS 111 online service.
Risks of fasting
- If you have complications associated with diabetes, such as poor vision or heart or kidney disease, the risk of aggravating these is very high and you should seriously consider not fasting
- For people with diabetes taking certain tablets and/or insulin, fasting carries the risk of hypoglycaemia. If you feel that you are having a hypo, you must break your fast and take some sugary fluids followed by starchy food as otherwise you will harm your body and may need medical attention
- You 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.
If you decide to fast
If, after consulting with your doctor, you decide to fast:
- If you are taking insulin, you will require less insulin before the start of the fast
- The type of insulin may also need changing from your usual type
- Pre-mixed insulin is not recommended during fasting
- Before starting the fast, you should include more slowly absorbed food (low GI), such as basmati rice and dhal, in your meal, along with fruit and vegetables
- Check your blood glucose levels more often than you normally would
- When you break the fast, have only small quantities food, and avoid only eating sweet or fatty foods
- Try to eat just before the break of dawn, when you commence the next day's fast
- At the end of fasting you should drink plenty of sugar-free and decaffeinated fluids to avoid being dehydrated.
Eid is a major occasion and celebrations involve lots of food which can be a challenge for people with diabetes, but having diabetes doesn’t mean you can't eat traditional festive foods. Just like everyone else celebrating, high fat and high sugar foods, such as barfi and rasmalai, can be enjoyed in moderation.
Throughout the day, it’s best to eat foods that are absorbed relatively slowly, such as basmati rice, chickpeas and dhal or biryani. These types of foods, and fruits and vegetables, can help keep blood glucose levels more stable during the celebrations. If you usually check your blood sugar levels, don’t forget to check them more often during the festivities to make sure they don’t get too high.
You can make some small changes to make traditional recipes healthier, for example replace sugar with sweetener and use semi-skimmed or skimmed milk instead of full fat milk. Choose healthier desserts such as fruit salads and low fat fruit yoghurt. Check out our Learning Zone for simple food swaps to make your meals healthier.
Download our factsheets about fasting and managing your diabetes during Ramadan, developed in partnership with the Muslim Council of Britain’s Diabetes Advisory Group:
If you are an Imam and would like more information on advising people with diabetes during Ramadan, download our short guidance document (PDF, 65KB).
Abdul, who has type 2 diabetes, explains why he chooses not to fast during Ramadan and suggests alternatives.
Further advice and guidance
Call the Diabetes UK Helpline on 0345 123 2399. If you wish to speak in another language, this can easily be arranged.
The Muslim Council of Britain has the latest guidelines and advice for Muslims fasting during the month of Ramadan to help them make the most of the blessed month. This information is also useful for the friends, neighbours and colleagues of Muslims.
For healthcare professionals, there is guidance on the management of type 1 and type 2 diabetes during Ramadan from the South Asian Health Foundation.