Insulin pump therapy in Moslem patients with type 1 diabetes during Ramadan fasting: an observational report.

Original article


Benbarka MM, Khalil AB, Beshyah SA, Marjei S, Awad SA.

Center for Diabetes and Endocrinology , Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Diabetes Technol Ther. 2010 Apr;12(4):287-90.


Background: Many Moslem patients do observe the fast during Ramadan. There are limited data on insulin pump therapy during Ramadan. We report our experience with type 1 diabetes patients on insulin pumps during Ramadan 2008 (29 days).
Patients and Methods: A total of 63 patients were evaluated. Forty-nine patients fasted, and 14 elected not to fast. Those who fasted (24 males, 25 females) were 22±7 years of age (mean±SD) and had had diabetes for 9.6±5.6 years. Patients used the Medtronic (Northridge, CA) MiniMed 722 model and had been using pump therapy for 20±10 months. Outcome measures included number of days fasted, hypoglycemia, unusual hyperglycemia, and number of emergency hospital visits.
Results: Thirty patients (61.2%) fasted the whole month with no problems, nine (18.4%) fasted 27–28 days, eight (16.3%) fasted 24–25 days, and two (4.1%) fasted 23 days. Nearly half of the patients decreased their basal insulin by 5–50% of their prefasting doses. Seventeen patients had hypoglycemia requiring breaking the fast. Fasting was broken on 55 out of 1,450 potential fasting days (3.8%). No severe hypoglycemia was reported by any patient. Unusual hyperglycemia was reported in nine patients (18.4%). Hospital visits were reported for one patient for hyperglycemia (a 16-year-old girl who disconnected her pump). Twelve patients had fructosamine levels measured both before and immediately after Ramadan; pre-Ramadan fructosamine level was 4.0±0.6mmol/L, and the post-Ramadan value was 3.6±0.6mmol/L (P=0.007).
Conclusions: Fasting during Ramadan is feasible in patients with type 1 diabetes using an insulin pump with adequate counseling and support.

Keywords: Insulin pump therapy in Moslem patients with type 1 diabetes during Ramadan fasting