REVIEWS
IMAJ | volume 27
Journal 10, October 2025
pages: 667-672
Pre-Ramadan Preparation for Safe Fasting in Patients with Type 2 Diabetes Mellitus
1 Division of Endocrinology and Metabolism, Zvulun Medical Center, Kiryat Bialik, Israel
2 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
3 Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
4 Department of Internal Medicine, Carmel Medical Center, Haifa, Israel
Summary
Pre-Ramadan fasting planning before the month of Ramadan represents a golden opportunity for better glucose control during the month of Ramadan among patients with type 2 diabetes mellitus (T2DM). Pre-Ramadan begins 1–2 months earlier and represents a crucial period when healthcare practitioners can provide medical instructions, risk assessment, and stratification to minimize the associated risks such as postprandial hyperglycemia and hypoglycemia during Ramadan fasting. This review focuses on two important classes of drugs that are widely used in Israel incretin-based therapy, particularly the glucagon-like peptide-1 receptor (GLP-1Rc) agonists class and the sodium-glucose cotransporter-2 inhibitors (SGLT-2i) class. In addition, we provide data regarding specific populations such as elderly patients and Bedouins living in the Negev area who require specific recommendations for safe Ramadan fasting. Our data are based on previously published guidelines, consensus statements, and our experience.