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1Clear out junk files and repair common Windows errors2Scan for outdated or missing drivers - takes under a minute3Repair Windows errors before they cause bigger problemsPeople who are pregnant or breastfeeding, children and adolescents, people with an eating-disorder history or prior severe hypoglycemia, and older adults with frailty or sarcopenia risk should generally avoid elective intermittent fasting. People with diabetes—or anyone whose medication could be affected by going without food or fluids—should get advice from their clinician before fasting. Do not stop or change medication on your own.
Who should generally avoid elective fasting?
A 2026 review advises against prescribing intermittent fasting to several groups because safety has not been established or fasting may be inappropriate for them. These include:
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- People who are pregnant or breastfeeding.
- Children and adolescents.
- People with a history of an eating disorder or severe hypoglycemia.
- People with frailty or sarcopenia, or at risk of developing sarcopenia.
These cautions concern elective intermittent fasting; they are not a universal ban on every fast undertaken for a medical reason. A medically directed fast, such as one required before a procedure, is different: follow the instructions of the treating team. The 2026 review discusses who should not be prescribed intermittent fasting.
Can people with diabetes fast?
Diabetes alone does not determine whether fasting is appropriate. Risk depends on glucose control, medication, prior low blood sugar or diabetic ketoacidosis (DKA), complications, the length and type of fast, and whether fluids are allowed. The American Diabetes Association’s 2026 Standards of Care say people with diabetes taking insulin or insulin secretagogues should be medically monitored during fasting and should have an advance assessment and treatment plan. The Standards address fasting and diabetes treatment.
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Get an individualized clinical assessment before fasting, especially if you have unstable glucose, recurrent DKA, hypoglycemia unawareness, frequent or severe hypoglycemia, significant diabetes complications, or use intensive insulin therapy. These risk factors also appear in the RSSDI’s 2017 recommendations, which call for physician consultation and pre-fast counseling. RSSDI’s recommendations are older guidance, so their date matters.
Fasting can cause low blood sugar, while reducing diabetes medication too much can contribute to high blood sugar and possible DKA. The scale of risk varies by person and fasting plan. In one study of people with type 2 diabetes fasting for Ramadan, 16.5% reported glucose above 300 mg/dL (16.6 mmol/L) on fasting days; this study-specific figure, reported in the ADA’s 2025 publication of its 2026 Standards, is not a rate for all people with diabetes or all fasting schedules. The ADA Standards provide the study context.
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Can I fast while taking medication?
Some medicines make fasting more complicated because they affect blood sugar or fluid balance. The medication name, dose schedule, health conditions, and type of fast all matter; this is not a complete list of medicines that need review.
| Medication or treatment | Why it matters during fasting | What to do |
|---|---|---|
| Insulin | Fasting increases concern about hypoglycemia. | Arrange a clinician-led plan and monitoring before the fast; do not alter doses on your own. |
| Sulfonylureas and other insulin secretagogues | These medicines can also increase the risk of hypoglycemia when food intake changes. | Ask the prescribing clinician how fasting would affect your treatment and monitoring. |
| SGLT2 inhibitors and diuretics | They can contribute to fluid loss, which is especially relevant if the fast prohibits drinks. | Discuss hydration and medication risks with your clinician before fasting. |
The NIDDK’s fasting guidance describes hypoglycemia as the main fasting risk for people with diabetes and also notes possible hyperglycemia, DKA, and dehydration concerns. Medication changes should be made only under a plan from the treating clinician.
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Does it matter whether a fast allows water?
Yes. A fast that prohibits fluids adds dehydration risk compared with a fast that permits water. Hyperglycemia can increase fluid loss, and NIDDK notes that diuresis related to SGLT2 inhibitors and diuretics may add to that concern. The actual risk depends on the person, medicines, health conditions, and fast. A glucose monitor may be part of a clinician-directed monitoring plan for some people with diabetes, but having one does not make fasting safe or replace medical advice. NIDDK explains these risks.
What should you do before considering a fast?
- Describe the fast. Tell your clinician how long it will last, whether it is repeated, and whether water and other fluids are allowed. Duration and fluid restrictions change the risk.
- Review your health and treatment. Discuss glucose stability, prior severe lows or DKA, complications, and every relevant medicine—especially insulin or a sulfonylurea.
- Agree on a monitoring and treatment plan. Ask what monitoring is appropriate, how treatment will be managed, and what symptoms or glucose readings mean you should end the fast or get help. Use the thresholds provided for your situation rather than assuming one number applies to everyone.
- Do not improvise medication changes. Do not stop, skip, reduce, or reschedule a prescribed medicine without instructions from the treating clinician.
Advance assessment and an individualized plan are emphasized in the ADA Standards and the 2019 review Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus.
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When should you break a fast or seek urgent help?
If you develop concerning symptoms or a dangerous glucose reading during a fast, follow the break-fast and urgent-care instructions in your personal clinical plan. The right thresholds and response depend on your circumstances; the cited guidance does not establish one universal cutoff for every person or fast. If you have diabetes and do not already have clear instructions for monitoring and responding to a problem, arrange that plan before fasting.
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- OPTIMIZE YOUR NUTRITION. Discover which foods work for you and those that don't. The Lingo app shows you how specific meals and other factors impact your glucose, so you can learn from your insights and build healthier habits
- NAVIGATE PREDIABETES WITH A NEW VIEW OF YOU. More time in healthy glucose range is linked to lower diabetes risk. Three out of four users with prediabetes say Lingo was effective in helping to achieve their health goals¹.
- HEALTHY GLUCOSE SUPPORTS HEART HEALTH. What you eat matters to your glucose and your heart. Keeping your glucose in a healthy range (70–140 mg/dL) more often can help protect your heart from heart disease²⁻⁴.
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