Type 1 diabetes and prolonged fasting.
J Reiter1, I D Wexler, N Shehadeh
1Division of Paediatric Endocrinology, Department of Paediatrics, Mt Scopus Canpus, Hadassah Hebrew University Medical Centre, Jerusalem, Israel.
Summary
Individuals with Type 1 diabetes can safely undertake prolonged religious fasts (>25 hours) by significantly reducing insulin doses and adhering to monitoring guidelines. Successful fasting requires careful management of blood glucose levels to prevent hypoglycemia or hyperglycemia.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Religious Studies
Background:
- Fasting is a common religious practice observed across various cultures and faiths.
- Individuals with Type 1 diabetes (T1D) often face challenges in maintaining glycemic control during fasting periods.
- Ensuring the safety of prolonged fasting for T1D patients requires specific protocols and monitoring.
Purpose of the Study:
- To evaluate the safety of prolonged fasting (>25 hours) in individuals diagnosed with Type 1 diabetes.
- To identify key factors contributing to successful fasting outcomes in this population.
- To assess adherence to safety protocols and identify adverse events during fasting.
Main Methods:
- A cohort of 56 individuals with T1D intending to fast were enrolled.
- Participants received standardized instructions on insulin dose adjustment, frequent glucose monitoring, and criteria for fast termination.
- Clinical and epidemiological data were collected, comparing successful and unsuccessful fasters.
Main Results:
- 65% (37 out of 56) of participants successfully completed their fasts.
- Fasting was terminated due to hypoglycemia or hyperglycemia; protocol adherence was high.
- No serious adverse events were reported. Successful fasters demonstrated greater insulin reduction and higher baseline HbA1c.
- No significant differences were observed between insulin pump users and those on intermittent injections.
Conclusions:
- Prolonged fasting is feasible and safe for individuals with Type 1 diabetes.
- Significant insulin dose reduction is crucial for safe fasting.
- Strict adherence to glucose monitoring and established guidelines for terminating the fast is essential for preventing complications.
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