6 Frequently Asked Questions on How to Manage Your Diabetes While Fasting

Whether you’re fasting for religious or health reasons, it can be challenging to stay on track with your health goals and manage your blood sugar levels at the same time. Your blood sugar levels are likely to become less predictable throughout the day, leading to a higher risk of hypoglycemia towards the evening. Plus, fitting in physical activity may be more difficult as low energy levels and lightheadedness may leave you feeling flat. To answer your questions, we chatted with Amirah Rahmat, Fitbit health coach and dietitian based in Singapore, about the challenges often encountered during periods of fasting, and how to make adjustments for a safer fast, so you can stay on track with your health goals. 

Note: It’s always a good idea to consult your doctor in advance of fasting for either religious purposes or health-focused purposes such as intermittent fasting. They may recommend you avoid fasting due to a high risk of complications. It may be safer to fast if you have well-controlled diabetes or manage your diabetes with medication and lifestyle, rather than insulin. Your doctor can also help to determine any adjustments that are needed to your medications and how frequently you should monitor your blood sugars. 

How can you try to increase your energy levels during this period? Not being able to eat or drink during the day can make you feel less energized. Some of the ways to tackle this is to distract yourself by doing things like light stretches and taking short brain breaks as needed. Using Fitbit’s reminders to move can help keep you lightly active in short bouts throughout the day. Try practising moments of mindfulness using the Relax feature on your Fitbit device. Taking afternoon naps may help you beat midday fatigue. And finally, try to ensure that you’re getting good quality sleep, so you can feel refreshed for the next day.

What should you eat before fasting? Try to eat a fibre and protein-rich meal to give yourself long-lasting energy. This could be a bowl of whole grain cereal with milk or Greek yoghurt and a side of fruit like a banana. Or even a small bowl of brown or wild rice with cooked, non-starchy veggies along with some chicken, tofu, or fish. Remember to drink plenty of water with your meal so you can go into your fast hydrated.

What should you eat to break your fast? It’s easy to overindulge after fasting. So, it’s important to choose wisely, eat slowly, and control your portion sizes to help avoid hyperglycemia. 

• Quench your thirst with a big glass of water or a cup of tea, rather than a sugary drink which might cause your blood sugar levels to spike. 
• Fill half your plate with veggies so you can ensure you’re getting enough fibre and nutrients after a day of limited intake. 
• Lean sources of protein are a great way of ensuring you feel full long after the meal is over. Fish, tofu, chicken, lean meat, beans, or eggs are all great options. 
• Include a small amount of high-fibre carbs like brown rice, sweet potatoes, or corn. If you’re breaking your fast with dates, stick to a small amount of only two to three dates.
• Opt for a healthier cooking method like baking, grilling, or steaming rather than frying, as a greasy high-fat meal may be difficult to digest on an empty stomach. 
• A helpful technique to feel satiated is to bring mindfulness to the dining table if you’re breaking your fast with family, putting aside distractions like television, computers, or mobile devices. Sit down at a table and try to eat slowly by chewing each and every bite—try counting to 30 before you swallow!

How can I recognise the signs that my blood sugar levels are too low? Skipping meals can lead to low blood glucose or hypoglycemia, which is when your blood glucose has fallen below the healthy range. Symptoms can happen quickly and can be different for each person, so it’s important to watch for the signs of low blood glucose. These can include:

• Sweating or clammy
• Trembling or shaky hands
• Irritable mood
• Irregular heart beat
• Extreme hunger
• Double vision
• Weakness
• Dizziness
• Headache

It’s important to monitor your blood glucose levels to detect hypoglycemia early. This is usually a reading below 70 mg/dL or 3.9 mmol/L. Checking your blood glucose does not break your fast, so you should do so if directed by your doctor. Don’t ignore your symptoms, as this can cause you to lose consciousness. If your blood sugar is consistently out of range, talk with your doctor immediately. 

How can you tell if you’re dehydrated? Dehydration is a common side effect of fasting, so it’s important to drink water as much as possible by taking small sips of water throughout the non-fasting hours. Look out for symptoms of dehydration which include:

• Weakness
• Confusion
• Dizziness
• Nausea
• Headache
• Fast heartbeat

What types of physical activity are safe to do? It’s best to avoid high intensity exercise during periods of fasting. If you live in a hot climate, exercising indoors can help you avoid dehydration. The best time to work out is after breaking your fast. Try light activity like going for a family walk after dinner. To help sustain you throughout the day try to focus on low-intensity activities that help improve flexibility and lower stress (e.g stretching, light yoga, meditation, or breathing exercises). However, if you are at a high risk of hypoglycemia or if you’re taking insulin/medications that increase insulin levels, you should avoid excessive physical activity.

Please note: Always consult with a health professional before fasting. Children with type 1 diabetes and pregnant women with diabetes or gestational diabetes are strongly advised not to fast due to the high risk of complications. 

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