Fasting During Festivals and Religious Occasions

Chapter 48 · Vihang Rahul Vasa

Before you read further: do not fast without asking your doctor first. For some people with diabetes, fasting can be dangerous: plasma glucose (blood sugar) can fall too low, or rise too high, without warning. What follows is how I manage fasting days, with my doctor’s approval. Your case is different from mine.

In India and across many cultures, fasting is deeply woven into religious and festival traditions: Navratri, Ekadashi, Ramadan, Karva Chauth, Lent, and many more. If you have diabetes, the desire to observe your faith through fasting is completely understandable and respectable. However, it requires careful planning.

• Always consult your diabetes specialist before undertaking any fast. They can adjust your medication timing and dosage to keep you safe.

• Prolonged fasting can cause hypoglycaemia, dangerously low plasma glucose (blood sugar), while the heavy meal at the time of breaking the fast can cause a sudden, sharp spike in plasma glucose (blood sugar). Both extremes are harmful.

• If you do fast, monitor your plasma glucose (blood sugar) more frequently than usual: before, during, and after the fast. On fasting days a continuous glucose monitor (CGM) is especially useful: it shows you, without finger-pricks, which way your plasma glucose (blood sugar) is moving through the fasting hours and warns you of a low before you feel it (see Chapter 16). Discuss it with your doctor, and use it during fasting days if advised by your doctor.

• Stay well hydrated during the non-fasting hours. Dehydration worsens plasma glucose (blood sugar) control.

• If at any point during a fast you feel dizzy, shaky, confused, or unwell, break the fast immediately. Your health comes first: most faiths acknowledge the exemption of the unwell from fasting.

(Reference for this chapter: Shaikh S, Latheef A, Razi SM, Khan SA, Sahay R, Kalra S. “Diabetes Management During Ramadan.” Endotext, NCBI Bookshelf, 2022: the medical reference on fasting safely with diabetes, including the IDF-DAR risk score your doctor may use. Full citation in the Appendix.)

Illustration: Chapter 48 illustrated summary. Fasting needs doctor assessment, an individual medicine plan, doctor-guided monitoring, CGM if advised, and hydration outside fasting hours.

Chapter 48 Fasting needs doctor assessment, an individual medicine plan, doctor-guided monitoring, CGM if advised, and hydration outside fasting hours. Dizziness, shakiness or confusion ends the fast. Health comes first.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.