This information was kindly provided by Dr. Ahmed Adel Hassan on the Diabetes Qatar Facebook Group
As i promised before, my recommendations regarding fasting the holy month of Ramadan for diabetic patients. We used to classify patient into two groups :
Group 1- insulin dependent DM patients and this patients can be classified into two groups
Group 1A – includes patients that are taking short acting insulin and this patients should not fast and they can provide meals to poor Muslims during the holy month of Ramadan.
Group 2B – includes patients that are taking long acting insulin like Lantus or Tresiba and this patients can fast and they should take 75% of the usual dose once daily during Iftar and they can increase the dose to the usual dose if fasting blood sugar become more than 120.
The other group is who are taking pre-mixed or mixed insulin and this patients can take divided dose 1st dose with Iftar (the usual full dose) and the 2nd dose can be given with Sohour with reduction of the dose to 75% of the total dose.
Group 2 includes patients who depend on tablets with or without Victoza or Trulicity these patient can fast and taking the tablets with Iftar (Forxiga) should be given immediately after Iftar and can take the 2nd dose if any with Sohour.
For all patients who are taking Glucophage they can take 1 tablet with Iftar and other tablet if any with Sohour.
GLP-1 RA (Victoza , Trulicity, Saxenda ) can be given 3 hours before Iftar and the injection will not break the fast.
We recommend to measure the blood sugar in the 1st 2-3 days of Ramadan fasting and 2 hours after Iftar to adjust the dose.
For those who are doing exercise , they should make it after Iftar
Since the weather became more hot we recommend fasting patient to avoid exposure to sun or to be in a hot place during fasting.
We recommend breaking the fast if blood sugar drop less than 70 mg or increase over 300mg .
I will be more than happy to reply to any questions and with arrangement with Mr. Justin we will arrange for an educational meeting for diabetics who are willing to attend during or after the Holy month of Ramadan.