How GLP-1 Drugs May Help Steady Blood Sugar During Ramadan Fasting

People with type 1 diabetes and those with type 2 diabetes who take insulin face particular challenges during Ramadan, the Islamic holy month when observant Muslims fast from dawn to sunset. The prolonged fasting period followed by eating at iftar—the meal that breaks the fast—creates an unpredictable pattern for blood sugar management.

During fasting hours, the risk of dangerously low blood sugar (hypoglycemia) increases, while after eating at iftar, blood sugar can spike sharply higher than usual. This combination of extreme highs and lows is called dysglycemia, and it puts people at risk for both immediate complications and longer-term health effects.

Researchers recruited 140 adults with type 1 or insulin-treated type 2 diabetes who use continuous glucose monitors (CGMs)—small devices that track blood sugar throughout the day. Of those screened, 54 people completed at least 14 full fasting days during Ramadan 2025 and were included in the analysis.

The study divided participants into three groups: people with type 2 diabetes on insulin alone, people with type 2 diabetes on insulin plus either semaglutide or tirzepatide, and people with type 1 diabetes on insulin alone. Researchers compared blood sugar patterns during four weeks before Ramadan, then during the entire 29 days of Ramadan, looking closely at what happened during fasting versus after eating.

The results showed that people who added semaglutide or tirzepatide—both GLP-1-based medications—to their insulin therapy experienced more stable blood sugar during Ramadan compared to those on insulin alone. This was particularly noticeable in the hours after iftar, when blood sugar typically climbs sharply.

The study suggests that the post-iftar period is when dysglycemia becomes most pronounced. By reducing the exaggerated blood sugar spike that follows the evening meal, the GLP-1 medications appeared to help smooth out the overall blood sugar pattern throughout the Ramadan period.

People with type 1 diabetes in the study used insulin alone, as the research did not explore adding GLP-1 medications to type 1 diabetes management during Ramadan.

This research adds to growing evidence that certain medications beyond insulin may help people with insulin-treated diabetes manage fasting periods more safely. GLP-1 receptor agonists like semaglutide and tirzepatide work by slowing digestion and helping the body regulate blood sugar—effects that may be especially valuable when eating patterns shift dramatically.

If you observe Ramadan and manage diabetes with insulin, this study suggests a conversation with your diabetes care team about whether adding a GLP-1 medication during the fasting month might help you. However, any changes to diabetes medications must be made in consultation with your healthcare provider, who understands your full medical picture.

As research in this area continues, these findings highlight the importance of using tools like continuous glucose monitors during Ramadan to see exactly how your blood sugar responds, and of working closely with your care team to find the approach that works best for you.

Source: Diabetes research and clinical practice. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.