Latest Advances in Therapeutic Recommendations for Managing Type 2 Diabetes in People Who Fast During Ramadan

Fasting during Ramadan is mandatory for all adult Muslims. However, those who are travelling or have an illness are exempted by religious guidelines from fasting, but have to give food or money to the poor and needy for each missed day of fasting. Despite this, many individuals with illness continue to fast, placing own lives at risk and creating a burden on their families and the healthcare system. Ramadan fasting introduces challenges for individuals with illness, such as diabetes, due to changes in nutritional habits, lifestyle patterns, and medication administration. This narrative review provides an overview of type 2 diabetes (T2D) management during Ramadan fasting.

A literature search was conducted using Google Scholar, Medline, PubMed, Scopus, and Embase for studies published between July 1979 and February 2026. Papers addressing T2D management during Ramadan were included based on clinical relevance, and studies not related to Ramadan fasting were excluded. Studies were selected through title, abstract, and full-text review.

Approximately 60 studies were identified. Current evidence indicates that some individuals with T2D continue to experience increased hospitalization rates during Ramadan, as reported in observational studies. Emerging evidence, based on observational studies and expert consensus with limited randomized controlled trial data, supports the potential benefit of a personalized pre-Ramadan 3-month low-calorie dietary program for those who still insist on fasting. This approach may improve glycemic control and reduce complications.

Integrating personalized pre-Ramadan dietary interventions into diabetes management guidelines may improve safety and reduce hospitalization rates among individuals with T2D who fast during Ramadan.