[DIABETES AND RAMADAN FASTING - UPDATE 2019].

INTRODUCTION: Fasting during the month of Ramadan and other religious fasting days presents a challenging issue for healthcare practitioners (HCP). Education and instructions for patients with diabetes who intend to fast is mandatory during the pre-Ramadan period. This period represents a golden opportunity to evaluate the general health status of the patients including their risk associated with fasting. Furthermore, it allows HCP to revise and adapt suitable changes for their anti- diabetic therapy before initiating fasting. Therapy with high safety profile agents such as incretin-based therapy is more favorable than therapy with moderate-low safety profile agents such as sulphonylureas(SUs) and insulin to be administrated during the month of Ramadan. Patients already receiving treatment with sodium glucose co-transporter 2 inhibitors (SGLT2i) need thorough medical evaluation during the pre-Ramadan period in order to enable them to fast safely during the month of Ramadan using this class of agents. The aim of this review is to provide HCP in Israel with instructions and recommendations for better management of diabetic patients during Ramadan, while taking into consideration the recently published data and therapies available in Israel.