Efficacy and safety of insulin pump in type 1 diabetes during fasting time (Month of Ramadan)

Waleed I. AlBaker¹, Ammar Khamis², Ahmed Abu Al-Hamayal

¹University of Dammam Consultant of Endocrinology

² University of Dammam, Department of Family and Community Medicine, Consultant of Biostatistics and Genetic Epidemiology

³MD University of Dammam

*Corresponding Author’s Email: dr_waleed99@hotmail.com

Accepted 03 January, 2013

Abstract

The insulin pump has proved to be an effective way to administer insulin in patients with Type 1 Diabetes. However, no data is available to assess its efficacy and safety in fasting diabetics' patients during the fasting time (month of Ramadan) .The purpose of this study was to compare the efficacy and safety of insulin pump in patients with type 1 diabetes mellitus already on the pump, who were fasting during Ramadan, as compared to patients with type 1 diabetes on multiple daily insulin injections and patients on premix insulin. Methods: This was a single center non-randomized trial design study. Patients with type 1 diabetes mellitus who were fasting received three types of treatments: patients received insulin through insulin pump (n =10), patients on multiple daily insulin injections (MDII) (n=5) and patients on premix insulin (CI) (n= 5). All patient groups are comparable in patient characteristics (Table 1). The patients were seen once before Ramadan (pre-Ramadan), and once after (post-Ramadan). Weight change, episodes of hypoglycemia, emergency visits, and days of breaking their fast were evaluated. Biochemical, FBS, HbA1c, and lipid profile were also evaluated. Findings: Most patients on insulin pump were able to complete their fasting during Ramadan (average 2 fast breaking per patient) with minimal episodes of mild hypoglycemia (2 episodes per patient), no episodes of hypoglycemia requiring assistance and no emergency room (ER) visits . No significant difference was found in biochemical profiles of patients on insulin pump who were fasting during the month of Ramadan as compared to patients on MDII. Both groups had better biochemical profiles than the group of patients managed with premix insulin. Conclusion: The insulin pump proved to be effective and safe in patients fasting Ramadan than other insulin regimen.

Keywords: Insulin Pump, Ramadan, Fasting, Type 1 diabetes.