Religious Fasting and Diabetes: A Review of Recent Guidelines and Research

Abstract

Background: Each year, millions of Muslims with diabetes fast during Ramadan, which brings with it specific metabolic challenges such as hypoglycemia, hyperglycemia, dehydration, and ketoacidosis. Methods: We reviewed diabetes management during Ramadan based on the American Diabetes Association's latest recommendations in 2025 and other authoritative sources. Findings: Conducting a comprehensive risk assessment and educating diabetic patients before fasting are crucial for reducing metabolic risks. Careful adjustment of the medication regimen and continuous glucose monitoring, especially in the final hours of fasting, are essential to prevent complications such as hypoglycemia, dehydration, and ketoacidosis. Adopting a person-centered approach to managing fasting and avoiding strenuous physical activity in the final hours will increase safety and improve health outcomes in fasting diabetic patients. Conclusion: The increase in Muslim patients with diabetes who fast during Ramadan has increased the willingness of reputable scientific communities to collect evidence and provide clinical guidelines based on it and has contributed significantly to improving the management of these patients. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved.