Ramadan and fasting with medical conditions

- 16 May 2018

Today marks the first day of Ramadan and the beginning of a month of fasting for many Muslims in Australia and around the world.

While it can seem like it’s a difficult thing to do, research lately has been proving the benefits of fasting in regards to heart health, mental health, and diabetes.

Ramadan isn’t just a month of fasting where nothing is to be consumed from sunrise to sunset for 30 days.
It’s used to demonstrate that you can exercise mind control over your urges.
From sunrise to sunset acts such as smoking, overt displays of anger, and sex are also prohibited. It is designed to give one control of ‘the self’, and to instil compassion for those who do go hungry without choice.

People are also encouraged to share meals after sunset with family and friends, and spend time on practising their faith, to renewed focus on spirituality and increasing social interaction.

However today I will be focusing on fasting in Ramadan for two reasons, fasting with a medical condition, and the overall benefits of fasting.

Fasting with a medical condition

There are accepted exemptions from performing a fast, and the list below might not be exhaustive;

  • – Children under the age of puberty and discretion
  • – People who are mentally incapacitated or not responsible for their actions.
  • – The elderly who are too old and feeble.
  • – The sick (more on this below)
  • – Travellers who are on journeys of more than about fifty miles
  • – Pregnant women and nursing mothers
  • – Women who are menstruating (days missed are made up later)

However I want to discuss fasting with a few specific medical conditions.

Diabetes

Patients who suffer from very stable and well controlled Type 1 or Type 2 diabetes can still fast, as long as they are aware of the changes they need to make in their medication.

Since there will be prolonged periods without any intake of water or carbohydrates, the actual load of glucose will be lower, often requiring an adjustment to their medication.
Those on tablets for type 2 diabetes would often take their medication with their evening meal for example and may need to withhold their morning and afternoon tablets.

Type 1 diabetics will likely need to reduce the amount of insulin they require.

It is strongly advised that you see your regular doctor before Ramadan to make sure that it is a healthy experience that helps you, and doesn’t result in hyperglycaemic or hypoglycaemic episodes that make you feel more unwell.

Patients on diuretics

If you are taking diuretic medicine (medicine that makes you urinate more) then you must also consult your doctor about how to modify your fluid intake and dosing during the month of Ramadan.

Those that take their medicines in the morning may need to adjust this, and might need to keep an eye on how much fluid is being consumed before sunrise and after sunset. Ensure your kidney function is stable and healthy before Ramadan begins, or even during Ramadan if you haven’t had the chance to. There are several resources that advise that having a blood test performed does not invalidate a fast and is permissible during Ramadan.

Acute illness

In the list above, it mentions that people who are sick do not have to fast. If you are acutely unwell with an illness like influenza, a cold, gastroenteritis, or any condition that requires you to take medicine or fluids, it is encouraged you do not fast on those days.

The benefits of fasting

Outside of Ramadan more and more research is showing that fasting, or intermittent fasting is having excellent results in improving diabetes, reducing cholesterol, insulin sensitivity, weight loss and improving our (sometimes unhealthy) relationship with food. People practice the 5:2 diet, the 16:8 hour fasts, alternate day fasting or other varieties that suit their lifestyle best. It’s great to read up on how these may fit what you do already, and how they can be helpful.

Have a look at this article from the Sydney Morning Herald, and this one from the ABC about fasting and its claimed benefits.

 

A final word

If you have any questions about your health and fasting in Ramadan or fasting outside of Ramadan for health reasons, come have a chat with one of our doctors for advice. Dr Daniel Chanisheff and Dr Shane Christensen have a particular interest in fasting for health.

So to those who will be participating in Ramadan, Ramadan Kareem!

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