Fasting for Festivals and Vrat

Fasting is part of ordinary life for many families — Navratri, Karva Chauth, Ekadashi, Ramadan and others. With diabetes it needs planning rather than simply being attempted.

The core issue is that going without food while continuing to take glucose-lowering medicine is a recognised cause of low blood sugar. Insulin, sulfonylureas and meglitinides are the medicines most likely to cause this. Metformin alone is far less risky.

So the first step is a conversation with your doctor before the fast, not after a problem. Your medicine doses or timing may need to change for that day, and that is a decision for your doctor to make.

During a fast, check your blood sugar more often than usual — not less, even though you are not eating. Low blood sugar is generally a reading below 70 mg/dL.

Know how you will break the fast if you need to. If you go low, treat it immediately with 15 to 20 grams of fast-acting carbohydrate, wait 15 minutes and check again. The method is the 15-15 rule. Every tradition that includes fasting also allows for illness, and a low blood sugar is a medical event, not a lapse of discipline.

The other half of the problem is the feast afterwards. A long fast followed by a very large, sweet meal produces a sharp swing in both directions.