Algorithm for premixed insulin titration during Ramadan (adapted from Hassanein et al23)
| Fasting pre-Iftar pre-Suhoor BG | Insulin adjustment |
|---|---|
| >16.6 mmol/L (300 mg/dL) | Increase insulin daily dose by 20% |
| >10 mmol/L (180 mg/dL) | Reduce insulin daily dose by 10% |
| 5.5–10 mmol/L (100–180 mg/dL) | No change |
| <5.5 mmol/L (100 mg/dL) or symptoms | Reduce insulin daily dose by 10% |
| <3.9 mmol/L (70 mg/dL) | Reduce insulin daily dose by 20% |
| <2.8 mmol/L (50 mg/dL) | Reduce insulin daily dose by 30–40% |