Fasting with Diabetes During Ramadan: A Practical Guide for Bangladeshis

Ramadan is one of the most important months of the year for Muslims across Bangladesh. For many people living with diabetes, the thought of fasting from dawn to sunset can feel a little worrying. The good news is that with the right planning and guidance from your healthcare team, many people with diabetes are able to observe Ramadan safely and comfortably. This guide shares practical, easy-to-follow tips to help you look after your blood sugar while honouring this special time.

Can People with Diabetes Fast During Ramadan?

Many people with type 2 diabetes do fast during Ramadan every year. Whether fasting is right for you depends on your individual health, the type of diabetes you have, and the medicines you take. Some people may be advised by their doctor not to fast, and Islam does allow exemptions for those with serious health conditions — this is a deeply personal decision.

Always Talk to Your Doctor First

Before Ramadan begins, book an appointment with your doctor or diabetes care team. This is the most important step you can take. Your doctor may adjust your medication schedule, give you a personalised meal plan, or advise you on when it is safe to break your fast. Never change your medication doses on your own.

How Fasting Affects Blood Sugar

When you fast for long hours, your body uses its stored glucose for energy. This can cause your blood sugar to drop. On the other hand, eating large amounts of high-carbohydrate or sugary foods at Sehri or Iftar can cause blood sugar to rise sharply. Understanding both risks helps you stay in a safer range throughout the day.

The Risk of Low Blood Sugar (Hypoglycemia)

Low blood sugar — called hypoglycemia — can happen when you have not eaten for many hours, especially if you take certain diabetes medicines. Signs include feeling shaky, sweaty, confused, or very weak. If you experience these symptoms while fasting, it is important to break your fast and treat the low blood sugar straight away. Your wellbeing always comes first.

The Risk of High Blood Sugar (Hyperglycemia)

Eating large portions of rice, bread, sweets, or fried foods at Iftar and Sehri can push blood sugar up quickly. Dehydration during the long fasting hours can also raise blood sugar levels. Choosing the right foods and drinking plenty of fluids between Iftar and Sehri helps manage this risk.

Smart Eating at Sehri (Pre-Dawn Meal)

Sehri is your fuel for the day. What you eat at this meal has a big effect on how your blood sugar behaves during the fasting hours. The goal is to choose foods that release energy slowly and keep you feeling full for longer.

Best Foods to Choose at Sehri

• Red rice or brown rice – digests more slowly than white rice, giving a steadier rise in blood sugar.
• Whole wheat roti or bread – a good source of slow-release carbohydrates.
• Eggs – high in protein, keeps you feeling satisfied.
• Lentils (dal) – full of fibre and protein, great for blood sugar control.
• Vegetables – leafy greens, cucumber, and tomatoes are low in carbohydrates and filling.
• Plain yoghurt – a source of protein and probiotics.
• A small handful of nuts – provides healthy fats and protein.

Foods to Limit at Sehri

• Large servings of white rice or white bread
• Very sweet foods or desserts
• Highly salty foods (they increase thirst during the day)
• Fried snacks like paratha with lots of oil
• Sugary drinks, including tea with lots of sugar

Smart Eating at Iftar (Breaking the Fast)

After a long day of fasting, it is natural to feel very hungry at Iftar. However, eating too much too quickly — especially sugary and fried foods — can cause a rapid spike in blood sugar. Try to break your fast gently and mindfully.

Best Foods to Choose at Iftar

• Dates (1–2 only) – the traditional and sunnah way to break the fast; keep the quantity small as they are high in natural sugar.
• Water and plain coconut water – rehydrate before eating a full meal.
• Vegetable soup or lentil soup – warm, filling, and gentle on blood sugar.
• Grilled or baked fish or chicken – lean protein without added oil.
• Salad with lots of vegetables – adds fibre to slow glucose absorption.
• A moderate portion of rice – not a huge serving; fill half your plate with vegetables first.
• Fruit – a small portion of low-glycaemic fruits like guava, papaya, or pears.

Foods to Limit at Iftar

• Fried items like beguni, piyaju, and samosa — enjoy very small amounts as a treat, not the main meal.
• Haleem, biryani, or polao in large portions
• Sherbets, juices, and soft drinks sweetened with sugar
• Mithai and other traditional sweets in large quantities

Checking Your Blood Sugar More Often During Ramadan

Regular blood sugar testing is one of the most helpful things you can do during Ramadan. Checking your levels helps you spot a high or low reading before it becomes a bigger problem. Using a reliable glucometer makes home testing quick and easy — a small pinprick check takes only a few seconds.

Good times to check your blood sugar during Ramadan include:

• Before Sehri
• A couple of hours after Sehri
• Mid-afternoon, especially if you feel unwell
• Just before Iftar
• About two hours after Iftar

Stock up on glucose test strips before Ramadan begins so you never run short. Keep your meter and strips somewhere cool and dry — avoid leaving them in a hot room.

When to Break Your Fast Immediately

Please break your fast right away if you notice any of the following:

• Blood sugar reading is very low (below the level your doctor has set for you)
• Blood sugar reading is very high (above the level your doctor has advised)
• You feel dizzy, shaky, sweaty, or confused
• You feel chest pain or severe headache
• You are vomiting or feel seriously unwell

Your health is more important than the fast. Islam permits breaking the fast when your wellbeing is at risk.

Staying Hydrated Between Iftar and Sehri

Dehydration is common during Ramadan, especially in the warm Bangladesh climate. It can make blood sugar management harder. Between Iftar and Sehri, aim to drink at least 8 glasses of water. You can also have herbal teas without sugar, plain coconut water, and thin soups. Avoid tea and coffee in large amounts as they can cause you to lose more fluids.

Carry a small water bottle with you in the evening so you are reminded to keep drinking. Spacing out your water intake across the evening hours is better than drinking a lot all at once.

Light Activity and Rest During Ramadan

Many people in Bangladesh go for a walk after Taraweeh prayers or do light household chores. Light to moderate activity is generally fine for most people with diabetes during Ramadan, but avoid intense exercise during the fasting hours as it can lower blood sugar too much.

Try to get enough sleep. Irregular sleep during Ramadan can affect blood sugar levels more than people realise. A short rest in the afternoon, if possible, can also help your body cope better with the change in routine.

Frequently Asked Questions

Disclaimer: This article is for general information purposes only and does not constitute medical advice. Every person's diabetes is different. Please consult your doctor, diabetes care team, or pharmacist before making any changes to your diet, activity, or medication during Ramadan or at any other time.