Diabetes Self-Management Blog

Because we are Muslim, every year for one month my family observes the fast for Ramadan. Fasting occurs from dawn until sunset; any time before and after we can eat as normal.

I’ve been fasting for the month for as long as I can remember. When I was really young, I of course didn’t have to fast, but my twin brother, my cousin (who is also my age), and I would try our best to fast even when our parents told us we didn’t have to. It was sort of a challenge for each one of us. We started out by fasting half days, but eventually graduated to fasting the entire time.

As a kid, fasting was never a real concern because up until age 10, I didn’t have diabetes. Once diagnosed, however, one of my biggest concerns was that I wouldn’t be able to fast. I know for a lot of people, especially young kids, getting diabetes would be the PERFECT out for not having to fast. For me though, it was the opposite.

Growing up, and to this day, Ramadan is always my favorite month out of the year. It’s about much more than simply abstaining from food and water. The month focuses heavily on gaining a stronger sense of spirituality, as well as working to improve yourself in general.

My fondest memories are smelling my mom’s delicious cooking while we’d count down the minutes until we could break our fast. (Now I’m responsible for helping out in the kitchen, and let me say, huge props to the moms cooking during Ramadan. It’s hard to be in the kitchen and not able to eat anything!) I always loved how packed the mosque would be during Ramadan because the community would come out for the night prayer called taraweeh.

When diagnosed, I was afraid that the month would lose it’s “magic” because I wouldn’t be able to fast. Luckily enough, I was diagnosed in December (which nine years ago, likely fell just after Ramadan). I was wearing a pump by that May, meaning it would be a lot more likely that I could fast, whereas on shots I had a very strict mealtime regimen. I actually remember my mom showing me an article she read about a boy who was able to fast because he wore an insulin pump. I was so happy!

To this day, a lot of people don’t understand how it’s possible that as someone with Type 1 diabetes I could possibly fast more than 18 hours. The short answer is, my insulin pump. Because my insulin pump functions as my pancreas, it gives me the basal rate (steady stream of insulin) I’d be getting throughout the day to maintain a stable blood glucose level in relation to the glucose secreted by my liver. To be honest, it’s so uncomplicated that I think people have a hard time comprehending the simplicity of it.

This Ramadan was a little bit more challenging than others, mainly because the entire month happened to be during my summer break. (The Islamic calendar is a lunar calendar, meaning that Ramadan goes back approximately 11 days every year). I have a tendency to stay up extremely late, even during the school year. The earliest I go to sleep is midnight, so the fact that Ramadan fell during summer basically meant that I was up until 4 AM for suhur (essentially, breakfast during Ramadan) and slept in until 1 or 2 PM.

Having such a warped sleep schedule meant I had to do some intense basal adjustments. It took me a while to get it just right. I had a tendency to spike around 5 AM despite prebolusing and to drop somewhere around 6 PM. There was one instance where I went to sleep around 1 AM and didn’t realize that my site had fallen out while I was asleep. I bolused for suhur, but of course nothing went into my system because the site was out.

I woke up an hour later with a blood sugar over 400, so I gave my correction and drank a huge glass of water. What people don’t realize with Ramadan is that health always comes first. If you have a medical problem preventing you from fasting, you are always excused. For me, I find that I’m able to fast about 95% of the time. On rare occasions that my glucose drops, I of course eat or drink something, and if I spike so high that I’m feeling lightheaded or anything like that I’ll have water and then resume fasting once things stabilize.

Because Ramadan has always been important to me, it was a huge priority that I figure out a way to maintain my fast. I know of people with diabetes who choose not to fast, and that’s totally their prerogative. I took one day off this month because my blood sugars in the morning were all over the place. I felt sapped of energy and decided it would be best to stay hydrated and fully energized for one day so I could get back into the swing of things.

In my opinion, fasting actually has a lot of health benefits, especially for people with Type 2 diabetes. I would really recommend looking into fasting for a day every month or every other month, as long as your health permits you to do so and your doctor gives you the OK. It’s great for your metabolism and is a great way to rid your body of any toxins. And the best perk, if you have Type 1 like me and wear a pump, is that it’s the ideal way to do a basal test!

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Comments
  1. I am so glad to read this blog entry! Thank you for sharing your thoughts and experiences about fasting during Ramadan. I am a nurse, and have many Muslim patients. Your personal experiences help me to understand them much better than any lecture ever could!

    Posted by Beth |
  2. Actually I am glad you are able to fast with the use of your pump. The thing with type 2 is that fasting is really not an option. The reason for this is that blood sugars actually go higher and can spike very high when one does not eat or drink water. One would think that it is only carbs that affect people with type 2 but one must remember that when one with type 2 doesn’t eat, the liver will have a party and spill glucose causing numbers to spike even higher. Once the person eats something even a couple of crackers with peanut butter the blood sugars will actually
    drop. I know that seems weird and of course I am not saying that to control type 2 one needs to eat. This only happens when one hasn’t eaten for several hours and ones blood sugar drops as a result and then the liver dumps its glucose.

    Posted by Kathy |

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