Endocrinology Unit, Internal Medicine Department, King Saud University, College of Medicine, Riyadh, Saudi Arabia.
Diabetes Center, Dr. Suliman Al-Habib Medical Group, Riyadh, Saudi Arabia.
Diabetes Care. 2024 Apr 1;47(4):683-691. doi: 10.2337/dc23-1968.
To compare the fasting experience and glycemic control during Ramadan among people with type 1 diabetes (PWT1D) who use automated insulin delivery (AID) versus other modalities of treatment.
A total of 294 PWT1D who attempted fasting during Ramadan in 2022 were categorized on the basis of treatment modality into one of five groups: 1) AID (n = 62); 2) conventional pump + continuous glucose monitoring (CGM; n = 37); 3) pump + self-monitoring of blood glucose (SMBG; n = 8); 4) multiple daily injections (MDI) + CGM (n = 155); and 5) MDI + SMBG (n = 32). Predictors of fasting most days of Ramadan (i.e., breaking fast ≤2 days because of diabetes) were analyzed using uni- and multivariable logistic regression.
The median numbers of days when fasting was broken because of diabetes were 2, 5, 3, 3.5, and 2.5 for AID, conventional pump + CGM, MDI + CGM, pump + SMBG, and MDI + SMBG users, respectively (P = 0.047). Users of AID had a significantly greater time in range (TIR) and lower glycemia risk index, time below range, and time above range compared with users of conventional pumps and MDI (both P < 0.05). Likewise, 53% of AID users attained the double target of 1) breaking fast ≤2 days because of diabetes and 2) maintaining TIR ≥70% during Ramadan compared with only 3% of the conventional pump users and 44% of the MDI + CGM users (both P < 0.05). Compared with MDI + CGM users, AID users were twice as likely to complete fasting most days of Ramadan.
Use of AID is associated with the highest rates of fasting and best glycemic control during Ramadan fasting.
比较在斋月期间使用自动化胰岛素输送（AID）与其他治疗方式的 1 型糖尿病患者（PWT1D）的禁食体验和血糖控制。
共有 294 名在 2022 年尝试在斋月期间禁食的 PWT1D 根据治疗方式分为五组之一：1）AID（n = 62）；2）传统泵+连续血糖监测（CGM；n = 37）；3）泵+自我血糖监测（SMBG；n = 8）；4）多次每日注射（MDI）+CGM（n = 155）；和 5）MDI+SMBG（n = 32）。使用单变量和多变量逻辑回归分析禁食斋月天数最多（即，因糖尿病而打破斋戒的天数≤2）的预测因素。
AID、传统泵+CGM、MDI+CGM、泵+SMBG 和 MDI+SMBG 用户因糖尿病而打破斋戒的天数中位数分别为 2、5、3、3.5 和 2.5（P = 0.047）。与使用传统泵和 MDI 的患者相比，AID 使用者的时间在目标范围内（TIR）更长，低血糖风险指数、低于目标范围的时间和高于目标范围的时间更低（均 P <0.05）。同样，53%的 AID 用户达到了 1）因糖尿病而打破斋戒的天数≤2 天和 2）在斋月期间保持 TIR≥70%的双重目标，而传统泵使用者仅为 3%，MDI+CGM 用户为 44%（均 P <0.05）。与 MDI+CGM 用户相比，AID 用户更有可能完成斋月期间大多数天数的禁食。
使用 AID 与在斋月禁食期间禁食率最高和血糖控制最好相关。
