- There should be a nutritional assessment reviewing carbohydrate (CHO) intake and recommendations about the proper food options for the two main meals of the day. Carbohydrate counting techniques should also be discussed.
- A basal insulin dose reduction by 10-30% has been recommended by the majority of experts and medical societies. More importantly, an individualized regimen should be considered and based on a review of the individual’s glucose profile within the first few days of fasting.
- The use of continuous glucose monitoring (CGM) or flash glucose monitoring (FGM) is superior to the traditional blood glucose monitoring and should be the method of choice if available.
- Individuals with Type 2 Diabetes Mellitus (DM) on three or more antidiabetic agents who fast during Ramadan, should receive counseling and comprehensive advice on diet, lifestyle and drug dose modifications prior to Ramadan.
N.B. Below are supplementary tables and figures that present adjustments and recommendations for insulin use during fasting and nonfasting hours for Type 1 and Type 2 DM respectively.
One Source: sections 9 and 10 of IDF-DAR Practical Guidelines 2021
Type 1 DM:
Type 2 DM