The objective of this article is to review important changes which may occur during Islamic
fasting in diabetic patients and the safety of fasting during the Islamic month of RAMADAN for
diabetics. Despite diverse findings regarding the physiological impact of RAMADAN on diabetics,
researchers have not yet found, in the diabetics who fast, any pathological changes in body
weight, blood glucose, HbA1c, C-peptide, insulin, fructosamine, cholesterol, or triglycerides. In the guidelines section of the article, we recommend that diabetic patients continue their regular
daily activity and diet regimen. It is also critical that diabetics adjust their drug regimen,
particularly those diagnosed as type 1 diabetes mellitus. These three important factors, i.e. drug
regimen adjustment, diet control, and daily activity constitute the “RAMADAN 3D Triangle”. With
3D attention, proper education, and diabetes management, we conclude that most type 2 and
some type 1 diabetic patients who insist on fasting can carefully observe RAMADAN.