Take Medicines Safely During Religious Fasting

Published March 1, 2024

Fasting means going without food and/or drink for a certain period of time. Some cultures and religious groups around the world fast during certain holidays. For example, during Ramadan, which begins on the evening of March 10 and ends on April 9 this year, Muslims who fast avoid eating and drinking from dawn until sunset. Another example is during Lent, many Christians fast, or limit/avoid meat on certain days between Ash Wednesday and Good Friday, which fall on February 14 and March 29 this year. However, these practices often make exceptions from fasting for certain populations (e.g., young children, people with diabetes, pregnancy, the frail and elderly). If people with medical conditions choose to fast during religious days, they may need to adjust how and when they take their medicine. It is important to talk to your doctor or pharmacist to help take your medicines safely while fasting.

If you decide to fast, you must know the best time of day to take any oral medicines that may need to be taken with or without food. If the medicine needs to be taken more than two times a day, your doctor may need to change it to one that can be taken one time a day. Some religious or cultural beliefs may only allow medicines that are given a certain way to betaken during the fast. For example, taking eye and ear drops, nasal sprays, inhalers, skin creams, patches, or injections while fasting may be allowed, but others may not.

People with diabetes who choose to fast may be at risk for serious health problems. For example, they are more likely to have low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), dehydration, and diabetic ketoacidosis (a serious condition that usually requires hospital treatment). This is due to a decrease in the amount of food and fluid that the patient takes and the time the meals are eaten. If medicine such as insulin is taken without eating enough food, you may have low blood sugar. If you do not take your insulin or diabetes medicine or if you are less active during your fast, your blood sugar may be high.

Here are some tips to follow if you have diabetes and plan to fast.

1. Before starting your fast, eat carbohydrates that give you energy slowly over time, such as rice, potatoes, pasta, fruit, and vegetables.
2. Check your blood sugar more often during the day.
3. When you eat, have small amounts of food, and avoid eating only sweet or fatty foods.
4. If you fast from dawn until dusk, eat right before daylight.
5. After the fast, drink lots of sugar-free, decaffeinated beverages so that you do not become dehydrated.

For people with diabetes who want to fast during Ramadan, we have included handouts in English and Arabic that can help with questions you may have. But please remember to talk to your doctor, pharmacist, and/or nurse (diabetes educator) about how to take your medicines during your fast.

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