Ramadan fasting presents an extra challenge for Muslims with diabetes

Tens of thousands of Muslims in Calgary are starting a month of fasting as Ramadan gets underway.

But Muslims with diabetes can find Ramadan and its religious obligations, including daily fasting, particularly difficult to navigate.

They need to take extra care around medications, diet and controlling blood sugar levels. 

But doctors say fasting, one of the five pillars of Islam, is still possible for some people who have Type 2 diabetes. Some can easily fast, others can fast with caution, or not at all, according to Dr. Fauzia Moyeen — but she said those with Type 1 diabetes can't even attempt to fast. 

"We've been working continually for the last month increasing the awareness among communities and doctors and nurses," said Moyeen, a diabetologist and international diabetes trainer who developed the condition herself two years ago.

"Firstly, we need to train people with diabetes to stay closely in contact with their physician, educators and pharmacists during Ramadan," said Moyeen.

Diabetes is a disease in which the body is not producing insulin, the hormone that controls glucose in the blood, or not properly using the insulin it can produce.

As well as problems with regulating blood sugar, overeating when breaking fast at the end of the day can also be a problem, being tempted by sweet treats and rich food, says Moyeen.

She says people with Type 2 diabetes who want to fast need to assess their risk before doing so, through their family doctor.

In Islam, children, elderly people, pregnant and breastfeeding women and people with illnesses are all exempt from fasting. But some still want to fast in some capacity.

Moyeen says altering expectations, like fasting for fewer days than everyone else and avoiding problem foods, can make it possible.

"Those who still want to, we help them," said Moyeen. "They also need to have a discussion with their physician."

Dr. Mukarram Zaidi, a family physician, says Muslims with diabetes should always contact their doctor before Ramadan to discuss a plan.

"In Islam, it's OK not to fast if your family physician tells you it's OK," said Zaidi.

Zaidi says Ramadan isn't about forcing people to fast.

"They need to get blood work done first and their doctor is the best person to tell them if they can fast," he said. "Also, seeing if their medications can be adjusted for Ramadan."

Zaidi says patients need to keep track of their calorific intake and avoid high glycemic index foods and items rich in sugars and deep fried foods, opting for slower-release carbohydrates, such as wholegrain bread and rice.

Ramadan runs through the month of April.