Automated insulin delivery for safe fasting and exercise during Ramadan in patients with type 1 diabetes: The active fast study.
Academic Article
Overview
abstract
AIMS: To evaluate the safe and effective use of the MiniMed™ 780G Advanced Hybrid Closed-Loop system (AHCLS) in adults with type 1 diabetes mellitus (T1DM) during Ramadan fasting combined with structured Moderate-Intensity Exercise (MIE) followed by the non-fasting month (Shawwal) with continued MIE. METHODS: This prospective, single-arm interventional study recruited 34 adults with T1DM using the MiniMed™ 780G. Participants performed MIE during non-fasting hours in Ramadan and continued it in Shawwal. Analyzed parameters included glycemic control, insulin requirements, usage of the MiniMed™ 780G system, metabolic parameters, and treatment satisfaction. RESULTS: Median time below range (<70 mg/dL) remained stable (1.0 %) across Ramadan and Shawwal (p = 0.39). Time in range (70-180 mg/dL) was significantly higher during Ramadan (70.5 %) than Shawwal (68.5 %, p = 0.0134), with a less median time above range(>180 mg/dL) in Ramadan (29 %) compared to Shawwal (30 %) (p = 0.0088). No severe hypoglycemia or DKA occurred. Participants demonstrated high treatment satisfaction and SmartGuard mode usage, with good adherence to fasting and exercise. CONCLUSIONS: Adults with T1DM can safely fast during Ramadan and exercise using the MiniMed™ 780G to manage diabetes. Findings from this study build on the real-world evidence to enhance clinical guidelines for optimal T1DM care using advanced technology.
