Answered by Shaykh Abdurrahman ibn Yusuf Mangera
Assalamu alaykum
In the name of Allah, the Inspirer of truth.
Type 1 diabetes is a serious problem. If this problem has been diagnosed in you and has been established in a concrete way, through consultation with an expert physician or diabetes specialist, then you will do the following:
If you have to forgo the fast in Ramadan but can keep them at another timeduring the year maybe in more shorter days of the year, then you have to make them up in those days that you feel better. Consult with a Muslim physician if there is some way to retain enough insulin through certain diets, medicine, etc. through the duration of the fast (especially nowadays when fasts are so short) and keep them.
Added note: Obviously with the prevalence of diabetes this is a commonly raised concern. There are two important issues in this matter (along with what has already been mentioned above). First, it is medically important that one distinguish between type I and type II diabetes. Second, before looking to exemptions in the shariah one with such problems should contact a Muslim physician who understands the importance of fasting. Such a physician can often come up with an altered insulin regimen for the periods of fasting. In most cases this issue can be resolved at this level
2. If this is not possible and the problem of headaches and vomiting remain a serious problem at all times (even after working with a new regimen of medicine and insulin), then you are considered a person incapable of fasting due to terminal weakness or illness. It is permissible for you to forgo your fasts and pay fidya instead (Tahtawi alal-Maraqi 453). It must be remembered though that in any case, if you somehow become capable of fasting again (even through advanced medicines or treatments), all the missed fasts will have to made up again, even if you had already paid fidya for them (Fatwa Hindiyya 1:207).
Wassalam
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