Today's Edition
SARA ALZAABI (ABU DHABI)
For many people with a chronic illness, Ramadan fasting is not a simple yes-or-no question. In clinics across the UAE, doctors say the difference between a safe month and a risky one often comes down to what happens well before the first day of fasting: a medication review, a realistic plan for meals and hydration, and clear “stop now” warning signs that patients agree on in advance.
Start Early, Plan Personally
Dr Nawras Abu Hamidah, Staff Physician within the Preventive Medicine Department of Cleveland Clinic Abu Dhabi’s Medical Speciality Institute, said that the most important step is early consultation with the treating physician to assess whether fasting is medically appropriate, review how stable the condition is, and rework medication timing and dosing so it fits fasting hours.
“Preparation is essential for individuals with chronic conditions who wish to fast,” she told Aletihad.
It is not just a formality, she stressed, but a safety check that becomes “especially critical for conditions such as diabetes, hypertension, heart disease, and gastrointestinal disorders, where medication schedules matter”.
Once a doctor has judged fasting to be reasonable, the practical details matter, Dr Abu Hamidah said, including shifting medication timing to non-fasting hours, planning balanced meals that support stable blood sugar or blood pressure, and taking hydration seriously between iftar and suhoor.
“These tailored strategies help reduce the risk of issues such as low blood sugar, dehydration, dizziness, or blood pressure fluctuations. When the plan is clear and practical, patients are much more likely to fast safely and comfortably.”
Diabetes: Numbers Decide When Fasting Stops
For people with diabetes, Dr Layan Ali Ibrahim, Endocrinology Specialist at Burjeel Day Surgery Centre, stressed that the most important safety tool is monitoring.
“It is essential to check blood sugar levels upon waking, before iftar, two hours after iftar, and at any time you feel unwell,” she told Aletihad, adding that fasting must be broken “immediately” if levels fall below 70 mg/dL or rise above 300 mg/dL to avoid complications.
Medication timing is another area where she said patients should not improvise, particularly for insulin users or those on oral agents that can increase hypoglycaemia risk.
For iftar, Dr Ibrahim advised a gradual start and a deliberate order that keeps blood sugar in check: 1-2 dates and a glass of water, then pausing briefly before moving on to the main meal. She also urged patients to limit fried snacks and Ramadan sweets because they can trigger sharp rises.
For suhoor, which she described as the most important for diabetes patients, Dr Ibrahim recommended delaying the meal as much as possible to shorten the fasting window and choosing fibre-rich complex carbohydrates plus protein to improve satiety and help stabilise blood sugar.
She added that practical habits, like avoiding strenuous activity, staying hydrated between iftar and suhoor, and maintaining good sleep, can reduce the risk of hypoglycaemia.
“When fasting is well planned, it can transform a challenge into an opportunity for improvement. Many patients, particularly those with type 2 diabetes, experience better disease control, as fasting may help improve blood glucose levels and enhance insulin sensitivity.”
Respiratory Conditions: Stable Lungs Need Routine
For people with asthma or chronic obstructive pulmonary disease (COPD), fasting can be safe if symptoms are stable, but it should be approached strategically, according to Dr Saheer Sainalabdeen, Specialist Pulmonologist at Medeor Hospital.
“Success lies in balancing religious or personal goals with clinical stability,” he told Aletihad.
“Patients must never discontinue preventer inhalers, as these maintain long-term airway stability. Consult a physician to reschedule doses between iftar and suhoor,” Dr Sainalabdeen added, pointing out that emergency rescue inhalers are “widely considered essential medical interventions that do not invalidate the fast”.
During fasting hours, he advised minimising exertion to conserve oxygen and avoiding environmental triggers like dust and second-hand smoke. During non-fasting hours, Dr Sainalabdeen recommended eating smaller meals to avoid diaphragm pressure and drinking 2-3 litres of water, warning that dehydration thickens mucus and raises obstruction risk.
“Ultimately, medical safety must take precedence. Fasting should be discontinued immediately if symptoms like severe wheezing, shortness of breath, or extreme fatigue occur. By following a structured plan, patients can fast safely without compromising their lung health.”
Heart Diseases: Stability Is the Deciding Factor
For patients with chronic cardiovascular diseases, the decision is heavily diagnosis- and timeline-dependent, according to Dr Kiran Bheemeshwar, Specialist Cardiologist at Lifecare Hospital.
"Heart patients should consult their cardiologist before deciding to fast," he told Aletihad.
Those with a recent heart attack, recent angioplasty, bypass surgery, heart failure, or uncontrolled arrhythmias are generally advised not to fast, while some stable patients may do so "under medical supervision".
Between iftar and suhoor, he advised gradually consuming 1.5-2 litres of fluids like water, buttermilk and light soups - unless the patient is on fluid restriction for heart failure - moderate and balanced meals, and light physical activity.
Dr Bheemeshwar added that medication schedules may need adjustment, especially diuretics and twice-daily drugs, and that sleep should not be sacrificed to late nights because it can raise blood pressure and cardiac strain.
