Ramadan and living with type 1: My experiences
Author: Nadeem Masood's story | Posted: 17 July 2015
By Nadeem Masood
Living with type 1 diabetes can be challenging. Everything we eat needs to be carefully considered. What’s my blood sugar level? Am I about to exercise? When is my next meal (if this is just a snack)? Have I recently eaten something low carb without insulin? If you carb count then almost every meal becomes a maths exercise. Have you ever weighed your food before diving in? Ramadan and living with type 1 is especially challenging.
As a Muslim, my diabetes control really gets tested during Ramadan, primarily because I won’t be eating. During the holiest month in the Islamic calendar Muslims around the world fast in the daylight hours. The routine is simple: get up before sunrise, have breakfast, consume nothing (including water) until just before sunset, eat for the rest of the evening, go to sleep. Repeat for one month.
Ramadan falls approximately ten days sooner every year, varying the length of the fast as the month goes from Winter to Summer and back again. At present we are in the Summer months when the days are longest, making fasting all the more challenging.
I was 31 when diagnosed with Type 1. Before then observing Ramadan hadn’t been an issue if, I must confess, I had chosen to do so. My attitude would change from year to year. With age my religious beliefs have strengthened so ever since diagnosis I have been seeking the answer to my dilemma about whether or not to fast.
Islamic law states that people with a chronic illness are exempt from fasting if doing so will endanger their health. Instead you must feed the poor for every fast missed (Fidya). Every doctor or nurse I have asked has stated that fasting is high risk and a bad idea. The internet is unreliable and causes confusion. Ask any imam or Muslim cleric and the response is to fast if possible without harming yourself, pay the Fidya, or make up the missed fasts during the Winter when the days are short. This is the preferred alternative. However, even during a very short day I may have a hypo. So the answer seems to be quite simple: I cannot fast at any time so I must feed the poor. I can now enjoy the luxury of eating during the day in a month when so many are voluntarily going hungry and becoming dehydrated.
The trouble is, I am a stubborn individual and I dislike taking the easy way out. I resent the fact that my condition is dictating how I should tackle fasting. I prefer to deal with it on my own terms. I try to fast every day. If I have a hypo I break my fast. No guilt, no issues, and at least I have tried. I help myself by making small changes to my usual routine. I stop cycling to work – around 10 miles in the saddle will never happen with an empty stomach and a lazy pancreas. I reduce my Lantus intake. I take the tram instead of walking to the station.
This year I have managed to keep half of the fasts. Whenever I have broken my fast I’ve wondered if I should even be attempting it. Ramadan is also about being a better individual, being kind and respectful, heightening your spirituality. I can do all of that without suffering hypos. Maybe my approach to Ramadan is wrong. During the first two years I didn’t fast at all. Perhaps my attitude will continue to change until I find the correct balance between body and mind. For now I will keep seeking the right answer and keep trying to fast.