Doctor Reveals Insulin Users Face Higher Risk During Fasting, Dose Adjustment Required

Diabetic patients using insulin face significantly elevated risk of blood sugar disturbances during fasting if their medication doses are not adjusted to accommodate changes in eating patterns.

Dr Bramantya Wicaksana, Consultant in Internal Medicine and Allergy-Immunology at RSU Hasanah Graha Afiah Depok, explained that insulin use requires special attention when patients choose to fast. “The most common health risks that arise are excessively low blood sugar and excessively high blood sugar,” Dr Bramantya said in an interview.

“This typically occurs in people with diabetes who use insulin, when they maintain their standard insulin dose but reduce their food intake significantly. This causes blood sugar to drop beyond safe tolerance levels,” he elaborated.

If the dose remains unchanged from normal days, blood sugar can drop dangerously low. Such conditions can produce symptoms including severe weakness, excessive perspiration, and even loss of consciousness—a situation that is dangerous if not immediately treated.

“Regarding insulin, the dose is generally reduced by 15 to 30 per cent, but this must be discussed with the attending physician,” Dr Bramantya stated. The dose reduction aims to align with eating times limited only to pre-dawn meal (sahur) and breaking of fast (berbuka).

This adjustment must not be undertaken independently without medical guidance. “Generally, people with diabetes can fast and must communicate this with their doctor. As long as they do not fall into a critical category, they can still fast,” Dr Bramantya concluded.