Fasting during Ramadan is not one decision that suits everyone. Some people with diabetes can fast safely after a medical assessment and a clear plan, while others are advised not to fast because the risk is too high. The most important steps are to discuss it with your doctor before the month begins, not to adjust your insulin or tablets on your own, and to break your fast immediately if your blood sugar drops below 4 mmol/L or rises above the limit your doctor has set for you [3].
Is fasting during Ramadan safe for people with diabetes?
The answer depends on your own condition. The guidance produced by Diabetes UK, in partnership with the British Islamic Medical Association, states that fasting may be dangerous for people with diabetes because it can cause health problems. For this reason, fasting is recommended only after discussing it with the diabetes team [3].
Diabetes is a condition in which blood sugar rises because the body does not produce insulin or does not use it properly [2]. People with type 1 diabetes need daily insulin doses, while some people with type 2 diabetes can control their condition through lifestyle changes, and others need medication [2]. This is why the risks differ from one patient to another.
Ramadan 2027 is expected to begin around 7 February [3], although the exact date depends on the sighting of the crescent moon. You therefore have a few months to prepare your plan with your doctor, which is a better option than waiting until the final week.
Who is exempt from fasting, and who has a higher risk?
The guidance notes that those exempt from fasting include children below puberty, elderly people, the sick, people with certain health conditions, people with learning difficulties, travellers, pregnant and breastfeeding women, and women who are menstruating [3]. Some people with diabetes may fall within the category of illness.
Your doctor will discuss several factors with you when assessing the risk:
| Factor | Its effect on fasting risk |
|---|---|
| Type of diabetes | Affects the assessment of risk [3] |
| Glycated haemoglobin (HbA1c) | Whether your average blood sugar is within the healthy range for your condition [3] |
| Type of medication | Insulin and sulphonylureas increase the risk of hypoglycaemia [3], as do medicines such as gliclazide and glimepiride [1] |
| Diabetes complications | Poor vision, nerve damage, and heart or kidney disease, which fasting may worsen [3] |
By contrast, according to the guidance, the risk is lower for a person with type 2 diabetes who relies only on diet and lifestyle, or who takes one medicine that does not increase the risk of hypoglycaemia, provided that their HbA1c is within the healthy range [3]. Poor vision deserves special attention, and you can read the guide to diabetic retinopathy.
If your doctor advises you not to fast
The guidance recommends asking an imam about alternatives if breaking the fast is required for health reasons [3]. Alternatives it mentions include charity and feeding the needy [3]. It also considers that failing to prepare medically before fasting conflicts with the prohibition on harming oneself (Surah Al-Baqarah, verse 195) [3].
When should you see your doctor before Ramadan, and what should you discuss?
Ideally, the appointment should be scheduled well before the month begins, to allow treatment to be adjusted if needed and the plan to be tested before the first day of fasting. Bring your blood glucose meter, your recent readings, and your complete medication list.
The guidance recommends that you discuss:
- the results of your recent tests, including HbA1c.
- the diabetes medicines you take.
- any existing complications or the likelihood of them developing [3].
- what is working well in controlling your blood sugar and what is not [3].
If diabetes is found to be poorly controlled before fasting, then according to the guidance, fasting will not be a safe choice this year [3]. This does not mean the door is closed permanently. You and your doctor may set a plan to improve your condition during the year so that you can reconsider fasting the following year [3]. You can use the diabetes care service to follow up on this improvement.
How is diabetes treatment adjusted before fasting, and why should you not adjust it on your own?
Your treatment may need to change when the timing of eating and drinking changes. The guidance notes that possible adjustments include:
- Diabetes tablets: you may need a different type or dose, and to learn the best time to take them [3].
- Insulin: your requirement may fall before fasting begins, you may need to change the type of insulin, and pre-mixed insulin is not recommended during fasting [3].
These are examples of what your doctor may decide, not instructions for you to carry out yourself. Do not stop any medicine or change its dose, timing, or the type of insulin without the direction of your doctor or pharmacist. If you cannot reach your doctor or the diabetes team and you are unsure what to do with your medications, it is best not to fast [3].
The approach in hypoglycaemia guidelines accepts adjusting the insulin dose when needed, but within the treatment plan agreed with the diabetes care team [1]. To learn about classes of medicines and how they work, read the guide to diabetes medications.
When must you break your fast?
Health comes first, and the plan agreed with your doctor includes clear limits for breaking the fast.
If your blood sugar drops
Hypoglycaemia (low blood sugar) is usually defined as blood sugar falling below 4 mmol/L [1]. If your blood sugar drops below this level while fasting, you must break your fast and treat the hypo with a sugary food or drink, then follow it with a starchy food. Otherwise, your health may be harmed and you may need medical care [3]. Check the unit of measurement on your meter (mmol/L or mg/dL) and ask your doctor for the equivalent value.
Symptoms that may alert you to a hypo include [1]:
- hunger, dizziness, sweating, and shaking.
- anxiety or nervousness, and a racing heartbeat.
- tiredness or weakness, and blurred vision.
- confusion.
In the event of a hypo, the guidelines recommend the following [1]:
- Take something that raises blood sugar quickly, such as a small glass of fruit juice or glucose tablets.
- Recheck your blood sugar after 10 to 15 minutes.
- If it remains below 4 mmol/L, repeat the treatment and recheck after 10 minutes.
- Once you have improved, take something that keeps your blood sugar stable for longer, such as the iftar meal if it is time.
It is recommended that you carry hypo treatment with you, along with a bottle of water, while fasting [3].
If your blood sugar rises
Ask your doctor before Ramadan: what is high blood sugar for me? If you exceed this limit while fasting, you should break your fast by drinking water and seek medical advice. Without this, diabetic ketoacidosis (DKA) may occur, a serious condition that requires hospital treatment [3]. Causes of high blood sugar while fasting include forgetting your usual medication, eating too many starches and sugars, and reduced physical activity. High blood sugar may also cause dehydration, dizziness, and tiredness [3].
The guidance also recommends not fasting when symptoms of an illness such as influenza appear [3].
Does checking blood sugar while fasting break the fast?
Diabetes UK explicitly states that checking blood glucose levels does not break the fast [3]. If you want complete religious reassurance, ask your mosque imam or a recognised fatwa authority. The guidance also recommends asking an imam about fasting-related questions [3].
Anyone taking medicines that raise the risk of hypoglycaemia should check their blood sugar more often during fasting, using a standard meter or a continuous glucose monitoring device [3]. You can ask your team about the appropriate timing for testing, and whether a continuous monitoring device is available [1]. Make sure you have enough test strips before the month begins [3]. To learn more about monitoring, see the blood glucose monitoring guide or how often you should check your blood sugar.
What should you eat at suhoor and iftar?
Delaying or skipping a meal increases the risk of hypoglycaemia for those taking certain medicines [1], which is why you should not skip suhoor, the meal before dawn [3].
| Meal | Helpful choices | What to avoid |
|---|---|---|
| Suhoor | High-fibre starches that are digested slowly, such as oats, bulgur, and brown rice, with attention to portion size [3]. Lentils, chickpeas, and fava beans are sources of protein and fibre [3]. | Eating too many carbohydrates. |
| Drinking before the fast begins | Sugar-free and caffeine-free fluids in sufficient amounts to avoid dehydration [3]. | Fizzy drinks and sweetened juices [3]. |
| Iftar | Water is the best choice for rehydration [3]. Unsweetened yoghurt is a good source of protein and calcium [3]. | Sweets rich in fat and sugar, such as baklava [3], and fried foods, except in moderation [3]. |
Dates are a source of fibre but are rich in carbohydrates: two large dates (30 grams without the stone) provide about 20 grams of carbohydrate, equivalent to a medium slice of bread. For this reason, the guidance recommends limiting yourself to one date to open the fast, or breaking the fast with a glass of water [3].
To help organise your meals in a way that suits Jordanian family tables, see meal planning for people with diabetes in Jordan, and you can book a diabetic nutrition consultation. You may also want to read how to manage banquets and social occasions, as evening gatherings and Eid add a dietary challenge even after the month has ended [3].
Warning signs: when should you see your doctor, and when should you go to the emergency department?
See your doctor if
- your hypos recur, or you have severe hypos or hypos during the night [1].
- you no longer reliably recognise the symptoms of a hypo [1].
- symptoms of high blood sugar appear, such as extreme thirst, frequent urination, exhaustion, and blurred vision [2].
- you feel dizzy and tired with high readings [3].
Call emergency services (911) or go to the nearest emergency department if
Someone has a seizure or loses consciousness [1]. In this case, do not give them food or drink because they cannot swallow safely. Place them in the recovery position, and give them glucagon injection immediately if it is available and you know how to use it [1]. Call an ambulance if the injection is not available or you do not know how to use it, if the person has not recovered within 10 minutes of the injection, or if they have consumed alcohol [1]. Stay with them until they have fully recovered. It is also recommended that your family and friends know how to act in the event of a severe hypo [1].
A rise in blood sugar above your limit with a worsening condition also requires urgent attention, as it may indicate ketoacidosis [3].
How do you find the right doctor for a Ramadan fasting plan for people with diabetes in Jordan?
Diabetes cases are usually followed by endocrinologists and diabetes specialists, or by family physicians and internists depending on your condition. You can start with the endocrinology and diabetes doctors in Jordan page, then narrow your search by governorate, such as Amman, Irbid, or Zarqa. Pages for other governorates are available in the directory. Health centres run by the Ministry of Health also offer nearby services in the governorates.
When reading a doctor's profile, look at their specialty, clinic location, working hours, and the contact or booking methods available. ClinicsJo is a directory for searching and contacting doctors. It does not provide consultations or prescriptions remotely, and it does not rank doctors by medical quality.
Prepare these questions for your appointment:
- Is my health condition suitable for me to fast this year?
- What should be adjusted in my medications or insulin, and when should I take them?
- At what level should I break my fast if my blood sugar rises or falls?
- How often should I check my blood sugar, and what should I do if I feel severely tired?
- What should I do if I become ill or cannot reach you?
Practical summary
Start early: make an appointment with your doctor, assess the risk, and create a written plan covering medications, measurements, and the limits for breaking the fast. Put your safety first, as fasting is a personal choice made after medical assessment [3]. And remember that any change to your medication must be made with your doctor, not as an individual decision.
Frequently asked questions
Can a person with diabetes fast during Ramadan?
Some people with diabetes can fast safely, but this depends on the type of diabetes, test results, medications, and complications. The decision is made after visiting your doctor before Ramadan and setting a clear plan. If blood sugar is not well controlled or the risk is high, your doctor may advise against fasting this year.
When should I break my fast if I have diabetes?
You should break your fast immediately if your blood sugar drops below 4 mmol/L or hypo symptoms appear, then treat it with a sugary food or drink followed by a starchy food. You should also break your fast with water and seek medical advice if your blood sugar rises above the limit your doctor has set for you.
Does checking blood sugar with a meter break the fast?
According to Diabetes UK, checking blood glucose does not break the fast, and people taking medicines that may cause hypoglycaemia are advised to check more often. If you have additional religious questions, ask your mosque imam or a recognised fatwa authority.
Can I adjust my insulin dose or tablets on my own during Ramadan?
No. Changing the dose, type, or timing is a decision your doctor makes after assessing your condition, as your insulin requirement may fall before fasting begins and the type may need to change. If you cannot reach your doctor and are unsure about your medications, it is best not to fast.
What should a person with diabetes eat at suhoor?
Do not skip suhoor. Choose high-fibre starches that are digested slowly, such as oats, bulgur, and brown rice, add a protein source such as legumes, and pay attention to carbohydrate portion sizes. Drink sufficient sugar-free and caffeine-free fluids. A nutrition specialist can prepare a list suited to your condition.
Can a person with diabetes break their fast with dates?
It can be done with caution, because dates are rich in carbohydrates: two large dates provide about 20 grams of them. Diabetes UK recommends limiting yourself to one date or a glass of water, and avoiding sweetened juices and fizzy drinks. Ask your doctor about the appropriate amount for you.
Sources and references
- Low blood sugar (hypoglycaemia) — NHS (UK National Health Service). Accessed: 2026-10-26.
- Diabetes | Type 1 Diabetes | Type 2 Diabetes — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Diabetes and Ramadan | Fasting | Diabetes UK — Diabetes UK. Accessed: 2026-10-26.
