3. INTRODUCTION TO RAMADAN 1.1
• Ramadan (Sawm) is one of the five pillars of Islam.
• This year it will start on 7 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)
5. 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)
7. 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.
8. 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.
9. 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.
12. 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)
14. 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.
15. 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).
16. 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.
18. 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)
20. 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)
22. 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)
23. 1.2
Eat of the good wholesome things.
(Surah Ta-Ha, Ayah 81)
25. 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.
27. REFERENCES
Websites
• www.diabetes.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.
