Summary Aims To compare insulin lispro with soluble human insulin in patients with Type 2 diabetes mellitus fasting during Ramadan, with respect to the rate of hypoglycaemic episodes and postprandial blood glucose values after the main meal after sunset. Methods The insulins were compared in an open‐label, randomized, cross‐over study of 70 outpatients. Hypoglycaemic episodes were recorded by the patients in a self‐monitoring diary. Fasting, 1‐h and 2‐h postprandial blood glucose values were recorded by the patient on three consecutive days at the end of each treatment period. Results The fasting blood glucose values before sunrise (P > 0.4) and after sunset (P > 0.6) were similar and did not differ significantly between both treatment groups. The rise in blood glucose after the main meal after sunset was 3.0 ± 0.4 mmol/l after 1 h in the insulin lispro treatment group compared to 4.3 ± 0.4 mmol/l in the soluble insulin treatment group (P < 0.01), and 2.6 ± 0.4 mmol/l after 2 h with insulin lispro compared to 4.0 ± 0.5 mmol/l with soluble insulin (P < 0.008). Mean hypoglycaemic episodes per patient over 14 days were 1.3 ± 0.1 vs. 2.6 ± 0.2, P < 0.002, respectively, f
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