Background: Fasting during Ramadan is an obligatory ritual for every healthy adult Muslim. However, a lot of type 2 diabetic Muslim patients insist on fasting whatever their health status. There are several potential physiological benefits from fasting, but the prolonged fasting hours during summer provides many questions about safety and efficacy of different insulin regimens used for the treatment of type 2 diabetic patients during Ramadan fasting. Objective: to assess safety and efficacy of different insulin regimens in type 2 diabetic patients who insist on Ramadan fasting.