US biomedical research agency, the National Institutes of Health, have found that prolonged fasting can be safe even for Type 1 diabetics, given insulin adjustments and strict glucose monitoring. Image Credit: Pexels

Abu Dhabi: For the majority of people, Ramadan is most closely associated with fasting. The holy month, however, presents a different, yet equally spiritual, experience for Type 1 diabetics.

Advised not to fast for their own safety, they, nevertheless, make the most out of this special time of year, engaging in self-reflection, worship and charity.

Imran Rafi Khan

“I was diagnosed with Type 1 diabetes when I was 11 years old. I need to take insulin injections twice a day, and I also need to eat something every two to three hours to prevent my blood sugar levels from dropping. As with all Type 1 patients, my blood sugars fluctuate widely, so it has never been possible for me to fast,” Imran Rafi Khan, 31, a banker from Pakistan, told Gulf News.

Caring for the needy

“That doesn’t mean, however, that I take anything less out of Ramadan. Because I cannot fast, I believe it is my responsibility to take care of the fasting needy. So every day, I pay for the iftar (evening meal to end the fast) and suhoor (predawn meal) for 15-20 people back home,” Khan said.

Fasting exemption

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Patients are therefore dependent on insulin to manage their blood sugar. If they fast, the absence of insulin can cause blood sugar to rise too high or fall too low, with health repercussions in both cases. Doctors therefore generally advise that Type 1 patients avoid fasting in Ramadan. And in Islam, anyone who is unwell, or can risk their health by fasting, is exempt from having to fast.

More to Ramadan

Khan said there is much more to Ramadan than just the days of fasting. “It is a month of charity, worship and learning. Apart from paying for meals for the needy, I also attend the nightly Tarawih prayers, and spend time reciting the Quran,” he said.

For Huda Hassan, 34, a Somalian behaviour therapist, the holy month is a time for reflection and family. “I’ve been living with Type 1 diabetes for the past 22 years, and I know fully well that even small changes in my routine greatly affect my blood sugar and well-being. When I was young, I did feel left out because I could not fast along with the other members of my family. But as I have grown, I’ve come to understand that there is much more I can engage in during the holy month,” she said.

Self-reflection, learning

Hassan spends a significant amount of time listening to religious lectures in Ramadan, and sets aside an hour a day for self-reflection. “And every single day, I sit down to iftar with my family because it is such a time of togetherness. Besides, it also coincides with my dinner time,” she said.

In recent years, certain studies, including a paper published in 2007 by the renowned US biomedical research agency, the National Institutes of Health, have found that prolonged fasting can be safe even for Type 1 diabetics, given insulin adjustments and strict glucose monitoring.

Hassan, who tried fasting one Ramadan, said that fasting in this manner is however “a full-time job”. “I tried fasting for a whole Ramadan a few years ago, and I was able to pull it off because I was working part-time and could rest during the day. Otherwise, basic activities at work can lead to dangerous shifts in my blood sugar, and I prefer to focus on the other aspects of Ramadan,” she said.

New experience

Zeeshan Hammaji

For Zeeshan Hammaji, not being able to fast during the holy month is still very new. The 25-year-old IT professional from India was diagnosed with Type 1 diabetes only last year. “I generally avoid it during the week. But I have managed to fast during the weekends this year, with the help of my brother, who helps me manage my blood sugar and insulin injections,” he said. “I am also focusing now on the nightly worship and congregational prayers to be able to make the most out of this month,” Hammaji added.