I am on insulin, can I keep fast on Ramadan?

[Farhid]

Hello, I am 41 years old and a type 1 diabetic patient. I am on insulin. Fasting during Ramadan, a holy month of Islam, is an obligatory duty for all healthy adult Muslims. Ramadan is a lunar-based month, and its duration varies between 29 and 30 days. Its timing changes with respect to seasons. Most people consume two meals per day during this month, one after sunset and the other before dawn. As I am diabetic, can I keep fast? Will there be any potential risk?

[Taposh]

@farhid Decreased food intake is a well-known risk factor for the development of hypoglycemia. Results of the Diabetes Control and Complications Trial (DCCT) showed a threefold increase in the risk of severe hypoglycemia in patients who were in the intensively treated group and had an average HbA1c (A1C) value of 7.0%. It has been estimated that hypoglycemia accounts for 2–4% of mortality in patients with type 1 diabetes. The largest dataset is the recent EPIDIAR study, which showed that fasting during Ramadan increased the risk of severe hypoglycemia (defined as hospitalization due to hypoglycemia) some 4.7-fold in patients with type 1 diabetes (from 3 to 14 events · 100 people−1 · month−1).