• It is very important not to stop taking insulin during Ramadan.
• Consider a lower dose (1/2 to 1/3rd of normal morning dose) at Sehri and usual full morning dose at Iftar time. (as a general rule)
• Consider changing from pre-mix insulin to long-acting insulin (eg; Isophane, detemir or glargine) to avoid higher risk of hypos at mid-day/mid-fast, either at Sehri or at Iftar.
• Pre-meal, short acting insulin analogues (Lispro and Novo-Rapid) are useful for fasting because they allow people to inject during or just after their break of fast meal, and give a lower risk of hypoglycaemia during the night. These have been shown to help with glycaemic control during Ramadan compared with regular human insulin.
• Where possible, take rest during the day to help avoid lowering of blood glucose levels.
