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. 2020 Mar;32(1):57–61. doi: 10.5455/msm.2020.32.57-61

Table 3. Physicians’ knowledge of the principles and practice of management of diabetes during Ramadan .

Question/Claim Number of physicians who provided correct answer %
Specific “Ramadan-focused education” is associated with better outcomes and less complications. 5 19
Patients with type 1 diabetes are not exempt from fasting and should not refrain from fasting. 7 26
Most hypoglycemic episodes occur during the last 2-3 hours of the fast. 24 96
Pregnant diabetic women should be advised to avoid observing the fast. 27 100
DDP-IV inhibitors have been shown to lead to less hypoglycemic episodes than sulphonylureas in general. 12 44
All sulphonylureas carry the same hypoglycemic risk potential. 23 85
SGLT2 inhibitors need to be used carefully in elderly patients and those with increased risk of dehydration. 0 00
“LIRA-Ramadan Study” concluded that GLP-1 therapy should never be used during Ramadan fasting. 6 22
If a patient who is observing the fast on insulin develops confirmed hypoglycemia, he should break the fast immediately. 19 70
Premixed insulin dose should be inverted with higher doses before Iftar (sunset meal) and reduced doses before Suhor (dawn meal). 14 52
It is prudent to reduce the doses of basal insulin to avoid day time hypoglycemia. 3 11
Patients on any type of insulin should not monitor their blood glucose during the day time as blood testing breaks the fast. 4 15