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6/22/16 – Sick or Elderly Fasting

June 22, 2016

Farooq Ahmed, MD

Quran permits Muslims to postpone fasting when they are sick, or, if one is not able to fast at all, compensate for it by feeding the needy.

Fasting is such a special and unique worship that according to hadith, “Allah (swt) said: ‘It [fasting] is done for Me and I shall reward for it…’” Fasting in Ramadan has so much attraction that even Muslims who may not be very observant during the rest of the year fast and flock to the mosques daily during Ramadan.

Fasting is not easy, especially in these hot and long summer days. Yet, in their eagerness to harness all the promised blessings of Ramadan, even sick or elderly people yearn to fast. The following are some general guidelines, precautions and good practices for safe fasting under a few common chronic conditions.


Since the fasts these days are very long, close to 17-18 hours, people tend to get dehydrated, especially the elderly. They start to feel the effects after the first few days of fasting. So, on a daily basis, drinking water, juices that are rich in electrolytes, like lemon juice or Gatorade will help cope with dehydration. Avoid eating spicy foods as they tend to make one thirstier. Eat fresh fruits, dates and honey. Keep a bottle of water when praying Taraweeh and take sips of water during breaks.


Every individual reacts differently to food and medicine, so please get the advice from your doctor as to how to manage diabetes during Ramadan. Also, consult with an Islamic scholar ahead of time about the permissibility of breaking the fast should you face difficulties.

For people who suffer from Diabetes, there are no clearly defined guidelines for managing one’s medicines during fasting. The main goal should be to avoid getting HYPOGLYCEMIA (very low sugar) which could be very serious to one’s health. In general, if someone is taking only one or two medicines for Diabetes, cut down the dose by one half and try to take it after breaking the fast and not during the Suhoor time as the chances of hypoglycemia are more during the long fasting hours. If someone is taking Insulin, then definitely cut down the dose by half and take it after breaking the fast. Avoid taking fast acting insulin. If you experience the signs of hypoglycemia please check the sugar levels instantly (this will not break your fast). Consult your doctor and break the fast if necessary per the advice of an Islamic scholar (consulted ahead of time).

Remember: Hypoglycemia (very low sugar levels) is more dangerous, as one can go into coma within a few minutes.

Arthritis and Back Pain

Due to work during the day and prolong standing during the Taraweeh prayers and lack of well hydration, muscles tend to get spasms and arthritis flares up during Ramadan. I suggest keep oneself well hydrated by drinking plenty of fluids during Suhoor and after breaking fast and use juices rich in electrolytes. Another thing which would help is to take a dose of acetaminophen (Tylenol) or Advil (ask your doctor if it is safe to take these medicines) before starting Taraweeh prayers. This would ease some pain and relieves back muscles and help arthritis pain.

Dr. Farooq Ahmed practices General Medicine and Geriatrics in the Chicago area. He has generously allowed emailing him with any questions at ahmed_farm@hotmail.com.

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