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Open Access
CC BY 4.0 · Journal of Diabetes and Endocrine Practice
DOI: 10.1055/s-0045-1811584
Original Article

The DAR Survey of Physicians' Use of GLP-1 Receptor Agonists and SGLT2 Inhibitors during Ramadan

Authors

  • Mohamed Hassanein 

    1   Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
    2   Department of Medicine, Mohamed Bin Rashid University, Dubai, United Arab Emirates

  • Bachar Afandi

    3   Department of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates
    4   Department of Medicine, CMHS, UAEU, Al Ain, United Arab Emirates

  • Salem A. Beshyah 

    5   Department of Medicine, College of Medicine, Dubai Medical University, Dubai, United Arab Emirates
    6   Department of Medicine, Bareen International Hospital, MBZ, Abu Dhabi, United Arab Emirates

Funding and Sponsorship None.
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Abstract

Background

While existing studies and guidelines have supported the safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors during Ramadan, little is known about how these recommendations are applied by physicians in real-world settings.

Objectives

This survey aimed to evaluate physicians' perceptions, practices, and use of GLP-1 RAs and SGLT2 inhibitors during Ramadan by assessing prescribing patterns, counseling approaches, and risk mitigation strategies.

Methods

A cross-sectional online survey was conducted in December 2024. The survey was disseminated via targeted e-mails and professional networks, including participants of prior DAR Alliance activities.

Results

A total of 939 physicians responded, with the majority from the Middle East and North Africa and South-East Asia regions. Endocrinologists accounted for over 40% of the sample. Most physicians reported treating over 50 patients with type 2 diabetes per month who fast during Ramadan. Endocrinologists were significantly more likely to initiate therapy earlier, adjust doses proactively, and provide structured counseling compared with non-endocrinologists, who exhibited more conservative and variable practices. Timing, dosing, and counseling practices varied, with some divergence between endocrinologists and non-endocrinologists. Nonetheless, both groups adhered to safety-focused strategies, including managing gastrointestinal side effects and reducing the risk of dehydration.

Conclusion

Although access to GLP-1 RAs and SGLT2 inhibitors is generally not a barrier, hesitancy persists among physicians in initiating or adjusting these agents during Ramadan. This variation may lead to inconsistent patient care and missed opportunities for optimal metabolic and cardiorenal protection. Clear, evidence-based guidance and structured training initiatives are essential to unify clinical practice and enhance patient safety in this unique setting.

Keywords

Ramadan fasting - type 2 diabetes - GLP-1 RA - SGLT2 inhibitors - hyperglycemia - dehydration - survey

Author Contribution

M.H. proposed the study; B.A. drafted the questionnaire; S.A.B. and M.H. revised and further developed the questionnaire. S.A.B. drafted the manuscript, and all authors revised and contributed to its development. All authors approved the final manuscript.


Compliance with Ethical Principles

The study was deemed to carry no hazard to participants. No formal ethical approval was sought. However, consent for voluntary participation on an anonymous basis was secured electronically before participants could access the survey questions.


Data Availability Statement

All data supporting the study can be made available in a de-identified format upon reasonable request to the corresponding author.




Publikationsverlauf

Artikel online veröffentlicht:
05. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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