Study investigates type 1 diabetes fasting risks and blood sugar control during Ramadan

A new study has investigated the risk of fasting during Ramadan for people with type 1 diabetes, and how insulin pump therapy compared to multiple daily injections (MDI) in controlling blood glucose levels.
Last year, the International Diabetes Federation (IDF) issued new guidelines for people with diabetes during Ramada, which is observed by more than one billion Muslims every year.
People with type 1 diabetes are not advised to fast during Ramada, which this year takes place between Friday 26 May and Saturday 24 June. This is because fasting while taking insulin can increase the risk of hypoglycemia. Insulin treatment should not be discontinued during Ramadan because this can raise the likelihood of diabetic ketoacidosis (DKA).
In this new study, conducted by the University of Colorado Denver, 156 participants with type 1 diabetes were observed, all of whom fasted during Ramadan.
The participants either used insulin pump therapy or MDI, with blood glucose data collecting using self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM).
While glucose variability was slightly better in the insulin pump group, there was no difference in blood sugar control or rates of hypoglycemia and hyperglycemia between the groups.
“To our knowledge, our study provides the first data about glucose profiles of patients with type 1 diabetes who use insulin pump therapy compared to those who use MDI during Ramadan fast,” wrote the study authors.
“Our data showed that these patients can safely fast during Ramada, a finding that concurs with other observations. However, a significant number of our patients had to break their fast due to hypoglycemia. Therefore, a careful selection of these patients with assurance of adequate education and supervision is important as acknowledged by the recent guidelines from the IDF.”
The researchers added that the clinical significance of these findings are not know, and further larger randomised studies are required to confirm the results.
The study has been published in Diabetes Technology and Therapeutics.