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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.

Diabetic Medicine : a Journal of the British Diabetic Association
|March 21, 2007
PubMed
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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.

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  • 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.