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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2026; 17(2): 115495
Published online Feb 15, 2026. doi: 10.4239/wjd.v17.i2.115495
Published online Feb 15, 2026. doi: 10.4239/wjd.v17.i2.115495
Safety and efficacy of sodium-glucose cotransporter-2 inhibitors in adults with type 2 diabetes fasting during Ramadan: A meta-analysis
Abul Bashar Mohammad Kamrul-Hasan, Department of Endocrinology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
Shehla Shaikh, Department of Endocrinology, Sir H.N. Reliance Foundation Hospital and Research Centre, Mumbai 400004, India
Hamid Ashraf, Rajiv Gandhi Centre for Diabetes and Endocrinology, Aligarh Muslim Uni
Mohammad Shafi Kuchay, Department of Endocrinology and Diabetes, Medanta-The Medicity Hospital, Gurugram 122001, Haryana, India
Lakshmi Nagendra, Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570004, Karnataka, India
Deep Dutta, Department of Endocrinology, CEDAR Superspeciality Healthcare, New Delhi 110075, Delhi, India
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, Greater Manchester, United Kingdom
Joseph M Pappachan, Department of Endocrinology, Countess of Chester Hospital NHS Foundation Trust, Chester CH2 1UL, Cheshire West and Chester, United Kingdom
Joseph M Pappachan, Department of Endocrinology, Kasturba Medical College and Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Author contributions: Kamrul-Hasan ABM, Shaikh S, Ashraf H, and Kuchay MS drafted the manuscript; Kamrul-Hasan ABM and Kuchay MS conceptualized the study; Kamrul-Hasan ABM and Nagendra L performed statistical analysis; Kamrul-Hasan ABM, Dutta D, and Pappachan JM formulated the methodology; Shaikh S, Ashraf H, Kuchay MS, and Nagendra L were involved in the literature search, study selection, and data extraction; Nagendra L, Dutta D, and Pappachan JM critically analyzed and revised the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abul Bashar Mohammad Kamrul-Hasan, Assistant Professor, De
Received: October 20, 2025
Revised: November 26, 2025
Accepted: December 30, 2025
Published online: February 15, 2026
Processing time: 111 Days and 20.7 Hours
Revised: November 26, 2025
Accepted: December 30, 2025
Published online: February 15, 2026
Processing time: 111 Days and 20.7 Hours
Core Tip
Core Tip: This meta-analysis assessed the safety and effectiveness of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in adults with type 2 diabetes fasting during Ramadan. Among 12 studies with 3625 participants, SGLT2i increased risks of postural dizziness, hypotension, and sodium loss, but achieved greater reductions in blood pressure and a lower risk of symptomatic hypoglycemia than other glucose-lowering drugs. SGLT2i did not impact glycemic control, body weight, or renal function. Other adverse events, like dehydration and severe hypoglycemia, showed no significant difference. SGLT2i appear safe and effective for diabetes management during Ramadan fasting, but larger studies are needed to confirm safety for vulnerable groups.