Department of Medicine, National University of Ireland Galway, Galway, Ireland.
Salmaniya Medical Complex, Manama, Bahrain.
J Diabetes Sci Technol. 2023 Mar;17(2):409-416. doi: 10.1177/19322968211059217. Epub 2021 Nov 22.
Various studies have evaluated the safety and efficacy of using insulin pumps during Ramadan; some of them demonstrated favorable outcomes in reducing hypoglycemia and hyperglycemia. However, there is no consensus on the recommendations for basal insulin adjustments and the utilization of technical features of insulin pumps to improve glycemic control.
We aimed to investigate the effects of different insulin pump settings on time in range in patients with type 1 diabetes during Ramadan.
In this randomized pilot study, 30 patients classified to have low to moderate risk for fasting were assigned to either a control group to receive basal insulin adjustments only or an intervention group to use the temporary basal rate and extended bolus features in addition to the basal insulin modifications. The percentage of time spent at different glucose ranges was measured by continuous glucose monitoring.
The percentage of time spent within target (70-180 mg/dL) increased significantly in the intervention group from 63.0 ± 10.7 to 76 ± 16.2% (mean difference, 27% points; < .001). The percentage of time spent in hyperglycemia level 1 (>180 mg/dL) and level 2 (>250 mg/dL) met the criterion of significance, indicating that the intervention group spent less time in hyperglycemia. However, there was no significant difference in the percentage of time spent in hypoglycemia ranges.
Incorporating technological approaches of pump therapy with clinical practice guidelines could improve glycemic control during Ramadan.
多项研究评估了在斋月期间使用胰岛素泵的安全性和有效性；其中一些研究结果表明，使用胰岛素泵可降低低血糖和高血糖的发生率。然而，对于基础胰岛素调整的建议以及利用胰岛素泵的技术功能来改善血糖控制方面，尚未达成共识。
本研究旨在探讨不同胰岛素泵设置对 1 型糖尿病患者在斋月期间血糖控制达标时间的影响。
本随机前瞻性研究将 30 例被归类为具有中低度禁食风险的患者分为对照组（仅接受基础胰岛素调整）和干预组（除了基础胰岛素调整外，还使用临时基础率和延长推注功能）。通过连续血糖监测来测量不同血糖范围内的时间百分比。
干预组的目标范围内（70-180mg/dL）时间百分比从 63.0±10.7%显著增加至 76±16.2%（平均差异，27 个百分点；<.001）。高血糖 1 级（>180mg/dL）和 2 级（>250mg/dL）水平的时间百分比也达到了显著标准，这表明干预组在高血糖水平的时间更少。然而，低血糖范围的时间百分比没有显著差异。
将泵治疗的技术方法与临床实践指南相结合，可以改善斋月期间的血糖控制。
