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Expert opinion

“There are so many ways to take part in Ramadan without fasting” – Nadia Malik, diabetes specialist pharmacist

We spoke to Nadia Malik, a clinical pharmacist at Queens Park Medical Centre, to find out how Muslims with type 1 can take part in Ramadan – whether they choose to fast or not.
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Josie Clarkson 12 February 2024

A selfie of Nadia Malik, a specialist diabetes pharmacist.

Ramadan is one of the most sacred times in the Muslim calendar. During the month of Ramadan, Muslims abstain from food and drink (yes even water!) from sunrise to sunset. This can present quite a challenge for people with type 1 diabetes

The good news? There are many ways to participate in Ramadan without fasting, while still embracing its spiritual and communal aspects.

People with type 1 are exempt from fasting

There have been times when I have had to omit fasting due to ill health during Ramadan, so I can appreciate how difficult not fasting can be when it is such an integral part of the faith. There are compassionate exemptions for individuals who may be at risk if they fast. This includes people with chronic illnesses, such as diabetes.

You wouldn’t be alone

Fasting during Ramadan is one of the five pillars of Islam and is thought of as an act of worship, as well as a means of empathising with those less fortunate. Fasting is mandatory for healthy Muslims after the age of puberty, but there are several exemptions including during pregnancy, breastfeeding, ill health or where fasting would be detrimental to health or wellbeing. If you are unable to fast, you are not alone; there are plenty of people in the same situation and there are other opportunities for you to make the most of this holy time.

A photo of two boys reading a book and celebrating Ramadan

A photo of two boys reading a book and celebrating Ramadan

Fasting is just one part of Ramadan

It’s easy to get overwhelmed or feel like you are missing out if you can’t participate in fasting. But there’s so much more to Ramadan than fasting. This month is about renewing one’s personal connection with God. Those who are exempt from fasting due to health reasons can still take part in Ramadan activities such as congregational prayers and gatherings.

The holy month offers opportunities for self-reflection, charity and prayer as well as the chance to be more spiritual and spend time with loved ones. Muslims perform prayers (called salah) five times a day and these prayers help provide spiritual discipline throughout the day. It’s also about personal growth, focusing your thoughts on helping others and improving yourself. Ramadan is a prime opportunity to reflect on your life and reset your routines.

Alternatives to fasting

Ramadan is a very family orientated time. If you are not fasting, you can still wake up before the start of Fajr (the dawn prayer) to join in and prepare the pre-dawn meal (suhoor) with your family. If you are waking for suhoor, then this might affect your sleeping schedule, even a half-hour power nap will leave you feeling refreshed.

Give charity

Charity is an integral part of the spirit of Islam, especially during Ramadan. You can help other people by giving one meal per fast that you miss to someone in need or donating the cost of each meal to a relevant charity. This is a form of charity called Fidya, which people who are unable to fast make in place of the fast.

You could also be charitable by volunteering in the community or helping at the mosque by serving food to people who have been fasting or to rough sleepers. You can even give back to others simply by being patient and kind. Take this month as an opportunity to be the best sort of person that you can be.

Ways to engage in Ramadan without fasting

Before deciding to fast, people with type 1 diabetes should consult their healthcare team to assess risks. Those unable to fast should know they are not alone — there are many permissible ways to observe Ramadan meaningfully.

Prioritising prayer & reflection

  • Focusing on gratitude and mindfulness during suhoor (pre-dawn) and iftar (evening meal) can bring a sense of unity with those fasting
  • Even if fasting isn’t possible, adjusting meal timings to align with suhoor and iftar can create a Ramadan atmosphere

Emphasising charity & acts of kindness

  • Paying fidya (feeding the less fortunate) is a meaningful alternative for those unable to fast
  • Volunteering in mosques, food banks, or helping neighbours fosters a sense of contribution to the community

Ramadan is about more than fasting – it’s about self-discipline, gratitude, and personal growth. So, by embracing the spiritual, social, and charitable dimensions of Ramadan, individuals with type 1 diabetes can fully participate in this blessed month without compromising their health.

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