I have type 2 diabetes treated with twice daily metformin and will be starting the Muslim fasting month soon. We are to eat only at dawn and dinner at dusk. What do you advise?

First, I would suggest that you can take your medication when you eat. Metformin is not supposed to cause severe hypoglycemia so I think you will do okay when you are fasting during the daylight hours. If you begin to feel low, you could decrease your metformin. However, decreasing it before the daylight fasting starts may not be the best since the metformin is helpful in keeping fasting glucose levels down.

JTL
Additional comments from Jane Seley, diabetes nurse specialist:

Since metformin is a long acting drug and does not cause low blood sugar, I would take it before dawn with a meal and again at dusk with the next meal. You might get stomach discomfort if you take it on an empty stomach.

JS