For the approximately 1.8 billion Muslims who observe Ramadan, the month involves fasting from dawn to sunset — typically 12–16 hours without food or drink, depending on location and time of year. For healthy people, this is manageable. For patients managing a health condition, the change in eating pattern, hydration and daily routine requires careful planning.
This guide covers the key considerations for patients with common conditions and how to adapt safely.
Who should consult a doctor before fasting
- People with type 1 or insulin-dependent type 2 diabetes
- Patients on medications that require food (e.g. metformin, NSAIDs) or have specific timing requirements
- Those with kidney disease or a history of kidney stones
- Patients with heart conditions on multiple medications
- Pregnant women — fasting during pregnancy carries risks
- Anyone on anticoagulants (blood thinners) — timing and monitoring need adjusting
Medication timing during Ramadan
The biggest practical challenge for many patients is adjusting medication schedules to align with fasting hours. The guiding principle is to minimise risk without compromising treatment efficacy.
- Once-daily medications can often be taken at iftar (breaking fast) or suhoor (pre-dawn meal) — confirm timing with your doctor or pharmacist
- Twice-daily medications may need to be redistributed — not simply taken both at iftar
- Metformin should be taken with food to reduce nausea — at iftar and suhoor is usually appropriate
- Insulin regimens often require significant adjustment for fasting — this must be planned with a diabetes care team
- Blood pressure medications may need dose timing review, particularly diuretics that increase thirst and urination during fasting hours
Monitoring during Ramadan
Patients with diabetes should monitor blood glucose more frequently — at least before suhoor, two hours after iftar, and whenever they feel unwell. The International Diabetes Federation and Diabetes and Ramadan (DAR) International Alliance publish specific guidelines on when to break the fast for safety:
- Blood glucose below 3.9 mmol/L (70 mg/dL) — break the fast immediately
- Blood glucose above 16.7 mmol/L (300 mg/dL) — break the fast
- Any symptoms of hypoglycaemia (shaking, sweating, confusion) — break the fast
Hydration and nutrition
Dehydration is a real risk, especially in hot climates. Prioritise hydrating fluids between iftar and suhoor — water, not sugary drinks or caffeinated beverages, which can worsen dehydration. Patients with kidney stones should aim for at least 2 litres of water in the non-fasting hours.
Suhoor matters: a balanced, high-fibre meal with complex carbohydrates and protein provides steadier energy and blood glucose through the fasting hours. Avoid salty, fried or high-sugar foods that worsen thirst.
Using Looms during Ramadan
The medication reminder feature in Looms can be adjusted to align with iftar and suhoor times — so your dose reminders fire at the right moment rather than in the middle of the fasting day. Keeping a log of blood glucose readings and any symptoms during the month also gives your doctor a complete record for next year's Ramadan planning. For context on what blood glucose numbers mean and when they warrant concern, see our guide to normal blood sugar levels.