Redistribution of oral antidiabetic doses during Ramadan

What it is

Table 3.5 sets out the modifications of patients' existing medications in T2DM. The pattern is redistribution, not a smaller daily dose: for most rows the daily dose is marked no change, and what changes is the hour, which is iftar, or iftar and suhoor. Only a few rows move the dose itself, and two of those only if good glycaemic control. A star against a drug carries the line at the foot of the table: not included in MoH Drug Formulary.

Metformin

• Prolonged release, OD: no change; take at iftar.
• Immediate release, OD: no change; take at iftar.
• Immediate release, BID: take at iftar and suhoor.
• Immediate release, TID: take morning dose at suhoor, combine afternoon and evening dose at iftar.

The TID row is the one worth holding: three doses do not stay three, they go to two, and it is the morning dose that moves to suhoor while the other two are combined at iftar.