Use of automated insulin delivery systems in people with type 1 diabetes fasting during Ramadan: An observational study

Abstract

Fasting among people with type 1 diabetes imposes the risk of metabolic decompensation. Automated insulin dosing systems can allow better glycemic control without safety concerns. The utility in prolonged and repetitive fasting has not been studied. In this observational study, validated glycemic data were reviewed and analyzed from people with type 1 diabetes who observed fasting during Ramadan in 2019 and 2020 using automated insulin dosing systems. Six profiles met the inclusion criteria. The average age was 33.7 ± 4.8 years, diabetes duration was 23.5 ± 7.9 years, body mass index 23.6 ± 1.9 kg/m2 and glycated hemoglobin was 6.3 ± 0.2% (45 ± 5 mmol/mol). The average glucose during Ramadan was 7.0 ± 0.5 mmol/L (126 ± 9 mg/dL), coefficient of variation 28.5%, percentage of time in range 3.9–10 mmol/L (70–180 mg/dL) 88.8 ± 7.3% and percentage time <3.9 mmol/L (<70.0 mg/dL) 2.5 ± 1.3%. The number of fasting days was 27.3 ± 3.3, and the number of days where fasting was broken due diabetes was 1 ± 1.5/participant. No significant differences in glycemic outcomes were noted between Ramadan and non‐Ramadan periods. In this first clinically validated study, automated insulin dosing systems showed a safe and effective management strategy to support prolonged and consecutive fasting in people with type 1 diabetes.

Insulin pump therapy and glucose control during Ramadan fasting in an adolescent with type 1 diabetes: from an open-loop sensor-augmented pump therapy with predictive low-glucose management to an advanced hybrid closed-loop system

“…Automatic basal adjustments and autocorrection with the MiniMed 780G are more practical and safer during Ramadan [ 3 , 5 ] and seem to be affected by the autocorrection algorithm specific to the MiniMed 780G. Similar to several other studies, we did not diagnose any diabetic ketoacidosis or severe hypoglycaemia during the month of Ramadan in either the SAP-PGLM or HCL, as reported in adults [ 2 ].…”

Ramadan Fasting and Diabetes (2022): The Year in Review

“…Validated glycemic data from people with T1DM who observed fasting during Ramadan in 2019 and 2020 using automated insulin dosing systems were reviewed and analyzed. 23 Six profiles met the inclusion criteria. The average age was 33.7 years, diabetes duration was 23.5 years, BMI was 23.6 kg/m 2 , and glycated Hb was 6.3%.…”

“…There was a large interest in studies involving technology during Ramadan fasting. 9,[23][24][25][26][27][28][29] These studies are summarized in ►Table 3. The highlights of these studies are discussed briefly below.…”

Ramadan Fasting and Diabetes (2021): The Year in Review

“…The utility of prolonged and repetitive fasting has not been studied. In an observational study, Aldibbiat et al 32 reviewed and analyzed validated glycemic data from people with T1DM who observed fasting during Ramadan in 2019 and 2020 using automated insulin dosing systems. Six profiles met the inclusion criteria.…”