Does Reducing Basal Insulin During Ramadan Fasting by Children and Adolescents with Type 1 Diabetes Decrease the Risk...

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Diabetes Management

Background:

• Ramadan fasting poses a risk of hypoglycemia for type 1 diabetes patients.
• Optimal basal insulin adjustment strategies during Ramadan are not well-established.
• This study addresses the lack of data on insulin adjustment during fasting periods.

Purpose of the Study:

• To investigate if reducing basal insulin during Ramadan fasting decreases symptomatic hypoglycemia in children and adolescents with type 1 diabetes.
• To evaluate the impact of basal insulin reduction on hypoglycemia frequency during Ramadan.
• To compare hypoglycemia occurrence between insulin pump users and multiple daily injection (MDI) users.

Main Methods:

• Enrolled children and adolescents with type 1 diabetes intending to fast during Ramadan.
• Collected data on fasting days, symptomatic hypoglycemia, and basal insulin doses via logbooks.
• Analyzed data from logbooks, glucometers, and insulin pump downloads.

Main Results:

• Sixty-eight patients' data were analyzed; 39 experienced hypoglycemia requiring breaking fast.
• Reducing basal insulin did not significantly alter the frequency of hypoglycemia.
• Hypoglycemia occurrence did not differ significantly between insulin pump users and MDI users.

Conclusions:

• This is the first study on basal insulin reduction impact on adolescent hypoglycemia during Ramadan.
• Reducing basal insulin during Ramadan fasting is not effective in decreasing symptomatic hypoglycemia risk.
• Insulin pump therapy and MDI showed similar hypoglycemia frequencies in this fasting cohort.