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The two case studies brought to you here by Diabetes & Primary Care will take you through the considerations of how to help people with type 2 diabetes prepare for fasting during the Islamic month of Ramadan. The scenarios provide different sets of circumstances that you could meet in your everyday practice. By actively engaging with them, you will feel more confident and empowered to manage effectively such problems in the future.


    1. Gilani A (2022) How to manage diabetes during Ramadan. Diabetes & Primary Care 24: 9–11;
    2. International Diabetes Federation (IDF), Diabetes and Ramadan (DAR) International Alliance (2021) Diabetes and Ramadan: Practical Guidelines 2021. Available at (accessed 24.02.22)
    3. Salti I, Benard E, Detournay P et al (2004) A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. The EPIDIAR study. Diabetes Care 27: 2306–11
    4. Babineaux SM, Toaima D, Boye KS et al (2010) Multi-country retrospective observational study of the management and outcomes of patients with type 2 diabetes during Ramadan in 2010 (CREED). Diabet Med 32: 819–28
    5. Hassanein M, Afandi B, Ahmedani MY et al (2022) Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract 185: 109185
    6. Diabetes UK (2017) Ramadan and diabetes. Available at: (accessed 24.02.22)
    7. Bravis V, Hui E, Salih S et al (2010) Ramadan Education and Awareness in Diabetes (READ) programme for Muslims with Type 2 diabetes who fast during Ramadan. Diabet Med 27: 327–31
    8. Aravind S, Al-Tayeb K, Ismail SB et al (2010) Hypoglycaemia in sulphonylurea-treated subjects with type 2 diabetes undergoing Ramadan fasting: a five-country observational study. Curr Med Res Opin 27: 1237–42
    9. Al-Arouj M, Hassoun A, Medlej R et al (2013) The effect of vildagliptin relative to sulphonylureas in Muslim patients with type 2 diabetes fasting during Ramadan: the VIRTUE study. Int J Clin Pract 67: 957–63
    10. Al-Sifri S, Basiounny A, Echtay A et al (2011) The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: a randomised trial. Int J Clin Pract 65: 1132–40
    11. 11. Hassanein M, Abdallah K, Schweizer A (2014) A double-blind randomised trial, including frequent patient–physician contacts and Ramadan-focused advice, assessing vildagliptin and gliclazide in patients with type 2 diabetes fasting during Ramadan: the STEADFAST study. Vasc Health Risk Manag 10: 319–25
    12. Anwar A, Azmi K, Hamilton B et al (2006) An open-label comparative study of glimepiride versus repaglinide in type 2 diabetes mellitus Muslim subjects during the month of Ramadan. Med J Malaysia 61: 28–35
    13. Fralick M, Schneeweiss S, Patorno E (2017) Risk of diabetic ketoacidosis after initiation of an SGLT2 inhibitor. N Engl J Med 376: 2300–2
    14. Wan Seman WJ, Kon N, Rajoo S et al (2016) Switching from a sulphonylurea to a sodium–glucose cotransporter2 inhibitor in the fasting month of Ramadan is associated with a reduction in hypoglycaemia. Diabetes Obes Metab 18: 628–32
    15. Brady E, Davies M, Gray L et al (2014) A randomized controlled trial comparing the GLP-1 agonist liraglutide to a sulphonylurea as add on to metformin in patients with established type 2 diabetes during Ramadan: the Treat 4 Ramadan Trial. Diabetes Obes Metab 15: 527–36
    16. Azar S, Echtay A, Wan Bebakar W et al (2016) Efficacy and safety of liraglutide compared to sulphonylurea during Ramadan in patients with type 2 diabetes (LIRA–Ramadan): a randomised trial. Diabetes Obes Metab 18: 1025–33
    17. British Islamic Medical Association (2022) COVID-19 Vaccine Hub. Available at: (accessed 24.02.22)
    18. The Muslim Council of Britain (2022) Latest COVID19 advice for British Muslims. Available at: (accessed 17.01.22)

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