Karachi: An estimated 24 to 26 million people living with diabetes in Pakistan observe fasting during Ramadan, but most do so without seeking prior medical advice, increasing their risk of preventable complications, health experts warned at a national diabetes conference.
The warning came at the 12th International Diabetes and Ramadan Conference, organised by the Baqai Institute of Diabetology and Endocrinology, where specialists stressed that fasting is safe for most people with diabetes if properly planned and medically supervised.
Experts urged people with diabetes to undergo pre-Ramadan risk assessment, adjust medicines and insulin doses with their doctors, and monitor blood glucose regularly during fasting. They clarified that checking blood sugar three to five times a day does not break the fast, and advised patients to break their fast immediately if glucose levels fall below 70 mg/dl or rise above 300 mg/dl with symptoms or complications.
They said breaking the fast in a life-threatening situation carries no religious penalty, other than making up the fast once health improves.
Speaking as chief guest, Prof Javed Akram, founder and former president of the Pakistan Society of Internal Medicine, said Pakistan has around 34.5 million people with Type 2 diabetes and about 300,000 with Type 1 diabetes.
He said regional and international data show that 70 to 75 percent of people with Type 2 diabetes fast during Ramadan, amounting to roughly 24 to 26 million individuals, while around 40 percent of people with Type 1 diabetes, nearly 120,000 patients, attempt fasting for at least part of the month.
“The issue is not fasting itself. The real concern is that most people do not consult their doctors before Ramadan to determine whether they are fit to fast and how their medicines, diet and hydration should be managed,” Prof Akram said.
He said Islam does not require people to place themselves in harm’s way and that medical advice effectively becomes religious guidance when health is at stake. Only 10 to 15 percent of patients are medically advised not to fast, he added, and such decisions should be left to healthcare professionals.
President of the Pakistan Society of Internal Medicine Prof Aftab Mohsin said Ramadan should promote discipline and restraint rather than overeating. He warned that poor dietary choices, irregular sleep and lack of planning often undermine the health benefits of fasting.
“Islam teaches moderation. People should eat sensibly at Sehri and Iftar, manage sleep better and focus on both spiritual and physical well-being,” he said.
Director BIDE Prof Zahid Miyan said the conference has been held for the past 12 years to bridge the gap between religious intent and medical safety. “Almost every person with diabetes wants to fast. Our aim is not to discourage fasting, but to ensure it is done safely,” he said.
Chairman of the organising committee Dr Muhammad Saif ul Haque said 70 to 85 percent of people with diabetes across Pakistan and the Islamic world insist on fasting, making structured education on safe fasting essential.
“People will fast regardless. Our responsibility as doctors is to help them do so with minimum risk,” he said, adding that hypoglycaemia and hyperglycaemia remain the most common Ramadan-related complications but are largely preventable through medical guidance.
Highlighting digital solutions, Dr Somia Iqtidar said local-language health apps and digital tools can help patients track glucose levels, receive medication reminders and follow safer dietary plans during Ramadan.
Cardiologist Prof Feroz Memon warned that Ramadan in Pakistan often turns into an eating-heavy routine dominated by fried and sugary foods. “Fasting benefits heart health only when accompanied by moderation and sensible food choices,” he said.
Other experts, including Prof Bashir Khoro, Prof Shabeen Naz Masood, Prof Shehla Javed Akram, Prof Hakim Ali Abro and Prof Asher Fawad, agreed that with timely medical advice, most people with diabetes can fast safely and gain both metabolic and spiritual benefits during Ramadan.
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