Ramadan and Type 1 diabetes

Observance of Ramadan and fasting from dawn to sunset is one of the five pillars of Islam for all mature and healthy Muslims, however Islamic rule does allow individuals with medical conditions not to fast. It is possible to fast if you have type 1 diabetes but planning is needed.  

Prior to Ramadan, you will need to make some changes to your diabetes care, including your insulin doses. Some preparation and safety recommendations are:

• speak with your diabetes team well before fasting to discuss a plan;
• always have insulin in your body, even when fasting. Continue giving your long-acting insulin (such as glargine or Levemir) at your normal time. Timing of rapid-acting insulin (such as NovoRapid, Apidra or Humalog) will change to before Iftar and Suhoor and usually the doses will need to change also. This can all be discussed with your diabetes team;
  
• always carry your blood glucose meter and hypo food;
• if your blood glucose is less than 4 mmol/L (hypoglycaemia) the fast must be broken with hypo treatment and
  
• have access to blood ketone strips and check for ketones if your blood glucose is 15mmol/L or higher. High blood glucose and ketones above 1.0 mmol/L means not enough insulin in the body and extra rapid acting insulin is urgently needed. 
  

Fasting is not recommended if:

• you have recently been diagnosed with diabetes;
• prior to preparation for Ramadan and fasting, you have made significant changes to your insulin doses or delivery regimen;
• you are unwell or become unwell during Ramadan or
• you do not regularly check your blood glucose levels and you forget to carry hypo food or
  

If you are an RCH patient planning to fast or just wanting to discuss if this is possible, please contact the diabetes allied health team via phone: 9345 6661 or email: diabetes@rch.org.au

Reviewed March 2023