The EPIDIAR study showed it long ago: the great majority of people with diabetes fast, including when their doctor advises against it. A message of prohibition produces mainly one effect: the patient fasts anyway, but without treatment adjustment and without monitoring. That is precisely the most dangerous situation.
One consultation, six weeks before
Good practice means assessing individual risk six weeks before the month begins. Well-controlled type 2 diabetes on metformin is low risk; type 1 diabetes, a history of severe hypoglycaemia or pregnancy are high risk, where fasting is genuinely inadvisable. Between the two, most of the work is redistributing doses between ftour and suhoor.
- Break the fast with three dates and water, then wait twenty minutes before the main dish.
- Move harira and starches to suhoor, where they hold blood sugar through the night.
- Check capillary blood glucose at least four times a day — this does not break the fast.
- Break the fast immediately if glucose falls below 0.70 g/L, without hesitating or waiting.
- Shift physical exercise to after ftour, never in the hour before.
Breaking the fast for a hypoglycaemic episode is not a failure, and every religious authority consulted on this point is unambiguous: preserving life comes first. Saying so plainly in consultation lifts a weight many patients carry alone.
The author
Dr Imane Sekkat
Head of Department — Nutrition & Diabetology
Imane Sekkat builds her meal plans from her patients’ actual meals — tagine, msemen and sweet tea included. She published a carbohydrate-equivalence reference adapted to Moroccan cooking, now used by several centres across the country.
Learn moreThis article is for information only and does not replace a medical consultation. If you have symptoms, please see a healthcare professional.
