Ramadan is a deeply meaningful month for millions of people in Turkey and across the world. However, for individuals living with diabetes, hypertension, heart disease, or kidney disease, extended fasting can introduce serious health risks that require careful medical planning.
The International Diabetes Federation estimates that a significant proportion of the world's 150 million Muslim diabetic patients choose to fast during Ramadan [1]Source: Diabetes and Fasting — International Diabetes Federation — International Diabetes Federation. In 2026, Ramadan falls during the winter-spring transition, which means shorter fasting hours — but the absence of food and water for 14–17 hours still creates physiological challenges that chronic patients must not underestimate.
This guide explains what physiological changes fasting triggers, which symptoms require emergency attention, and when to call 112 or Nova Ambulans (0216 339 00 39) without delay.
Disclaimer: This content is for educational purposes only and does not replace professional medical advice. If you have a chronic condition, consult your doctor before fasting.
How Ramadan Fasting Affects the Body
During the fasting hours, the body undergoes several interrelated changes:
- Blood sugar fluctuations: In patients using insulin or medications that stimulate insulin secretion, prolonged fasting can dangerously lower blood glucose (hypoglycaemia) or allow it to rise out of control (hyperglycaemia).
- Dehydration and electrolyte imbalance: Cutting off water intake can rapidly create problems for anyone with reduced kidney function or those taking diuretic medications.
- Disrupted medication metabolism: Medications designed to be taken twice daily cannot simply be condensed into one dose without clinical supervision.
- Increased cardiovascular load: Combined dehydration and fasting can raise blood viscosity, placing extra strain on the heart and circulatory system [3]Source: Diabetes — American Heart Association — American Heart Association.
Diabetes Patients and Ramadan Fasting
The most common question among diabetic patients is: "Can I fast safely?" The answer depends heavily on the type of diabetes and current treatment. The IDF-DAR Practical Guidelines categorise patients into high, moderate, and low risk groups to guide this decision [2]Source: IDF-DAR Practical Guidelines — Diabetes and Ramadan — International Diabetes Federation.
Type 1 Diabetes
Due to complete insulin dependence and the volatility of blood glucose levels, Type 1 diabetic patients face very high risk when fasting. These patients should not fast without explicit approval from their endocrinologist [1]Source: Diabetes and Fasting — International Diabetes Federation — International Diabetes Federation[2]Source: IDF-DAR Practical Guidelines — Diabetes and Ramadan — International Diabetes Federation.
Type 2 Diabetes
Patients managing Type 2 diabetes with lifestyle changes alone, or with low-hypoglycaemia-risk medications such as metformin, may fast with lower risk. However, patients on insulin or sulphonylureas (e.g. glibenclamide, gliclazide) must work with their doctor to restructure medication doses and timing before Ramadan begins [2]Source: IDF-DAR Practical Guidelines — Diabetes and Ramadan — International Diabetes Federation.
Monitoring Blood Sugar While Fasting
Testing blood glucose with a fingerprick device during fasting does not break the fast, according to both medical authorities and most religious scholars [1]Source: Diabetes and Fasting — International Diabetes Federation — International Diabetes Federation. Recommended monitoring and action thresholds:
- Check blood glucose at least 2–4 times per day during the fasting period.
- If glucose falls below 70 mg/dL — break your fast and seek medical attention.
- If glucose exceeds 300 mg/dL, especially with nausea or vomiting — seek emergency care immediately.
- For severe hypoglycaemia symptoms (confusion, shaking, loss of consciousness) — break your fast at once; this is also a religious obligation.
Hypoglycaemia Symptoms and Emergency Response
Hypoglycaemia can become life-threatening within minutes, particularly in patients on insulin or sulphonylureas. Key warning signs include [1]Source: Diabetes and Fasting — International Diabetes Federation — International Diabetes Federation:
- Sudden profuse sweating and trembling
- Racing or pounding heartbeat
- Severe dizziness or headache
- Difficulty concentrating, drowsiness
- Blurred vision, tingling around the mouth
- Confusion or loss of consciousness
Critical: If the patient loses consciousness, cannot swallow, or fails to improve within 15 minutes of receiving sugar, call 112 or Nova Ambulans (0216 339 00 39) immediately. The ambulance team can administer intravenous glucose on the spot.
For step-by-step guidance on what to do while waiting for help, see our guide for relatives waiting for the ambulance.
Hypertension (High Blood Pressure) Patients and Ramadan
Hypertension is one of the most prevalent chronic conditions in Turkey. Extended dehydration combined with disrupted medication timing can cause blood pressure to spike or drop unpredictably [3]Source: Diabetes — American Heart Association — American Heart Association.
Rescheduling Medication — Only With Your Doctor
Once-daily medications can often be safely moved to suhoor or iftar timing, but this decision must not be made without your doctor's guidance. Compressing twice-daily medications into a single dose without supervision risks overdose or inadequate blood pressure control.
Stay Ahead of Dehydration
- The fluid loss between suhoor and iftar raises the risk of hypertensive episodes.
- Drink plenty of water after iftar and again at suhoor.
- Avoid high-sodium foods (pickles, processed soups, cured meats) that exacerbate fluid retention.
Emergency Warning Signs
The following symptoms may indicate a hypertensive crisis — call 112 or Nova Ambulans immediately:
- Severe headache + blurred vision + facial flushing
- Measured blood pressure above 180/110 mmHg with any accompanying symptom
- Chest pain or shortness of breath alongside elevated blood pressure → see our chest pain and shortness of breath guide and call 112 without delay
