Fasting is not an uncommon practice, and people fast (restrict food intake) for a variety of reasons, including the preparation of certain medical procedures, detoxification and religious purposes. Although some religions excuse individuals with diabetes from fasting, because of the risk of medical complications, many people still want to participate in this type of religious ritual.

Fasting can lead to elevated blood sugar levels (hyperglycemia) or low blood sugar count (hypoglycemia), if not carefully monitored. Dangerous consequences of hyperglycemia (high blood sugar) include: dehydration and potential risk of blood clots. On the other hand, when blood sugar levels drop too low, seizures are possible and the risk of a heart attack may increase. In addition, if low glucose levels are not immediately treated, dehydration is possible, as well as mental confusion and other symptoms that may lead to a coma.

Another problem that may arise during a fast is a diabetic patient’s refusal to continue their prescribed medication.

To fast safely, diabetics may consider the following advice:

Patients, family members and friends must be aware of the symptoms associated with hypo/hyper glycaemia.

Blood sugar levels must be checked more often during a long period of fasting, especially insulin depend diabetics.

While fasting, excessive activity should be avoided, but regular physical activity (such as walking and/or gardening) can continue.

When breaking a long time fast, high sugar foods should be avoided, and high fiber foods should be the focus.

A fast should be immediately broken if blood sugar levels reach levels above 300 mg/dl.

Although it is recommended that individuals that have Type 1 diabetes do not fast at all, more than 40% of insulin dependent Muslims will participate in a 30 day fast (known as Ramadan).

Continual and honest communication should occur between a patient and their primary care physician during a long time fast, to ensure safe blood sugar levels.