Table 2

Categories of risk in patients with type 1 or type 2 diabetes who fast during Ramadan

Very high risk
    Severe hypoglycemia within the 3 months prior to Ramadan
    A history of recurrent hypoglycemia
    Hypoglycemia unawareness
    Sustained poor glycemic control
    Ketoacidosis within the 3 months prior to Ramadan
    Type 1 diabetes
    Acute illness
    Hyperosmolar hyperglycemic coma within the previous 3 months
    Performing intense physical labor
    Chronic dialysis
High risk
    Moderate hyperglycemia (average blood glucose 150–300 mg/dl or A1C 7.5–9.0%)
    Renal insufficiency
    Advanced macrovascular complications
    Living alone and treated with insulin or sulfonylureas
    Patients with comorbid conditions that present additional risk factors
    Old age with ill health
    Treatment with drugs that may affect mentation
Moderate risk
    Well-controlled diabetes treated with short-acting insulin secretagogues
Low risk
    Well-controlled diabetes treated with lifestyle therapy, metformin, acarbose, thiazolidinediones, and/or incretin-based therapies in otherwise healthy patients
  • Note: This classification is based largely on expert opinion and not on scientific data derived from clinical studies.