Is it safe to fast with diabetes? Doctors speak

Ramadan 2026 is here for millions of Muslims in Nigeria and across the World to commence fasting during the daytime. Also, it’s about another period of the year when diabetic patients ask several questions about their health and the possibility of fasting despite being diabetic. 

Several questions are asked daily: Is it safe to fast despite being diabetic? Can I break my fast when I start experiencing discomfort? Are there drugs to use to make me fast effectively and as expected without any adverse effects? These and many others are what people with diabetes issues are likely to be othered with during this period.

In this article, Tribune Online discusses how diabetic patients can still tweak their ways to fast, and also those who aren’t encouraged to fast due to possible complications. 

But before then, let’s talk about Diabetes…

What’s Diabetes?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. 

Diabetes has caused a significant rate of mortality across the globe. In 2021, diabetes was the direct cause of 1.6 million deaths, and 47% of all deaths due to diabetes occurred before the age of 70 years.

Doctors Speak 

Speaking in an interview with Tribune Online,  Dr. Aliyu Shehu, who works at the Federal Teaching Hospital, Birnin Kebbi, explained that it is generally safe to fast with diabetes, unless there are contraindications. 

“The contraindications could be a diabetic patient with poorly controlled blood sugar, a diabetic patient who usually experiences hypoglycaemia (low blood sugar) with symptoms such as restlessness, excessive sweating, dizziness, tremors, or even loss of consciousness, and patients who are on insulin injections, diabetic patients with other serious complications”, he said.

He further stated that patients who are not on insulin and take their medications once or twice daily can take their medications during sahur and at iftar and proceed to fast without any problem. However, patients who are on insulin should consult their doctors before commencing fasting.

According to him, diabetes patients with no serious complications before fasting for the day should immediately break their fast when they start experiencing symptoms of hypoglycemia or hyperglycemia.

“A diabetic patient who starts to experience symptoms of hypoglycaemia, such as dizziness, excessive sweating, restlessness, tremors,  or symptoms of hyperglycaemia such as excessive thirst and excessive urination, must immediately break the fast and see a doctor”, he added.

In another interview, Dr. Jonas-Attabo Samson of the Federal Teaching Hospital Katsina, said Diabetes, also known as Diabetes mellitus in this context, is classified into different types, but basically there are two types: type 1 diabetes mellitus, also known as the insulin-dependent type or the early-onset diabetes mellitus, and type 2 diabetes mellitus. 

He further stated that some studies have shown that it’s safer for people with type 2 diabetes to go on a fast than for people with type 1 diabetes mellitus.

“For people with type 1 diabetes mellitus,  particularly if they are in need of insulin at multiple times of the day or maybe morning and evening, it’s not recommended to fast. Although some things could be done for such a person to fast but generally, it’s not recommended to fast.”

“For type 2 diabetes mellitus, it’s really safer for them to fast, particularly if there’s no already chronic complications. But if there are complications like kidney disease, cardiovascular problems, such a person isn’t recommended to fast as well. People with high rates of hypoglycemic and hyperglycaemic complications are not recommended to fast as well,” Dr. Jonas-Attabo explained. 

Continuing, Dr. Jonas noted that some recommendations could be made to enable diabetic patients to fast, which include patients carrying out continuous glucose monitoring throughout the day. 

He also recommended that the sahur (pre-dawn meal) should have more carbohydrates, and other very complex carbohydrates for sahur, adding that the iftar meal should not be very heavy but lighter than the sahur meal. 

In addition, he recommended that people measure their glucose control levels over time.

 “Both Muslim and Christian faithfuls willing to fast should always check their glycaemic control before fasting commences. It’s important to always consult your doctor to assess your glycaemic levels first.”