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Does Cystic Fibrosis and Diabetes Exempt You from Fasting?

10 March, 2026
Q I would really appreciate guidance on the following matter according to the Hanafi madhhab. I have read that individuals with chronic illnesses may be exempt from fasting, and that fasting could even be sinful. However, I have also come across opinions stating that people with diabetes may still be required to fast and make up missed fasts. This has left me uncertain about my own situation. I have cystic fibrosis and CF-related diabetes, both of which are chronic conditions. To manage my health, I take at least nine different medications daily, including multiple insulin injections. While I can choose when to take my medications, there are certain times of day that are medically optimal. Although my diabetes is currently well controlled, I am unsure whether fasting would be harmful in the long term. I also came across the following resource discussing the medical risks of fasting with cystic fibrosis, which suggests that one may be exempt but should consult an imam: https://www.cysticfibrosis.org.uk/about-us/resources-for-cf-professionals/supporting-clinicians/resources-for-clinicians/nutrition-leaflets/fasting-during-ramadan My main concern is that while fasting may not be immediately life-threatening, it could potentially cause long-term harm. I am also underweight and struggle to gain weight due to cystic fibrosis, and I worry that fasting could worsen this. At the same time, I am concerned about whether I am sinful for not properly exploring this matter and trying to take the easy way out by avoiding fasting without sufficient justification. My doctor is not Muslim, so I am unsure how to weigh their medical advice in this context. With all this said, am I considered exempt from fasting? If not, how do I make up for 15 Ramadans of missed fasts without causing harm? JazakAllah khair for your time and guidance.

Answer

In the Name of Allah, Most Gracious, Most Merciful. 

All praise and thanks are due to Allah, and peace and blessings be upon His Messenger.


In this fatwa:

According to the Hanafi school, a person with chronic illnesses such as cystic fibrosis and CF-related diabetes is exempt from fasting if fasting may harm their health. Because the illness is permanent, missed fasts do not need to be made up. Instead, the person pays fidyah by feeding one poor person for each missed fast.


Responding to your question, Sheikh Ahmad Kutty, a senior lecturer and an Islamic scholar at the Islamic Institute of Toronto, Ontario, Canada, states:

According to the Hanafi school, you are fully exempt from fasting due to your chronic illness (cystic fibrosis and CF-related diabetes). Since this condition is permanent and fasting could potentially harm your health, you are not required to fast.

Because your illness is chronic and not expected to improve, you do not need to make up missed fasts. Instead, your obligation is fidyah, which involves feeding one poor person for each missed fast.

For each missed fast, you should feed one poor person or provide food of equivalent value. In Canada, this typically amounts to $20 per fast. You can pay the fidyah directly to a charity or through local Islamic centers. If you have missed multiple fasts in previous Ramadans, you can pay the fidyah gradually over time based on your capability. This clarifies the practical steps and options available to fulfill your obligation.

Islam exempts individuals whose fasting would result in harm, severe hardship, or worsening of illness. In your case, fasting poses risks due to:

• Dehydration associated with cystic fibrosis
• Blood sugar instability from diabetes
• The necessity for regular medication and nutrition

Therefore, protecting your health takes priority, and fasting in this situation is not required by Islamic law.

It is important to remember that:

• There is no sin for the years you did not fast due to illness.
• Reliable medical advice is sufficient, even if the doctor is not Muslim.
• Instead of fasting, you can enhance your Qur’an recitation, duʿa, prayer, and charity during Ramadan.

To conclude:

• You are exempt from fasting due to chronic illness.
• No make-up fasts are required.
• Fidyah is required (feeding a poor person for each missed fast).
• You may pay fidyah gradually if needed.

May Allah grant you ease, healing, and great reward for your patience, and may He accept your worship. Ameen.

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Almighty Allah knows best.

About Sheikh Ahmad Kutty
Sheikh Ahmad Kutty is a Senior Lecturer and an Islamic Scholar at the Islamic Institute of Toronto, Ontario, Canada