ESPE Abstracts

Background: Ramadan is the holy month of fasting for Muslims. New evolving technology in the treatment of type 1 diabetes (T1DM) had encouraged Muslim diabetics to pursuit the practice of fasting. There are limited data on fasting of children and adolescence with T1DM during the holy month.

Objective and hypotheses: Our aim is to investigate the ability, effect and safety of children and adolescence with T1DM to fast the Holy Month of Ramadan 2014.

Method: This was a prospective observation study of children and adolescence with T1D for at least one year who intended to fast the Holy month of Ramadan 2014. Pre Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. The following clinical outcomes were investigated before, during and after the Holy month: glycosylated haemoglobin A1C (HbA1C), number of days fasted, number of hypoglycaemia and hyperglycaemia episodes, and number of emergency hospital visits.

Results: A total of 50 children and adolescence were recruited with a mean age of 12.7±2.1 years, 23 (46%) were males and 27(54%) were females. 27(54%) of cases were on multiple daily injections (MDI) insulin regimen and 23(46.0) were on pump therapy and there was no significant difference between two groups as regards mean age, gender, duration of diabetes, and HbA1C prior to Ramadan. The children fast a mean of 20.0±9.9 days. Most common cause for breaking the fast was mild hypoglycaemia (mean blood sugar during the attacks (3.04±0.31). Two patients had had one episode of DKA during fasting due to lower respiratory tract infection and pump failure respectively. HbA1C after Ramadan was predicted by pre-Ramadan HbA1C (r=0.533).

Conclusion: Fasting in children with T1DM above the age of 10 years is feasible and safe in both pump and non-pump users. Pre-Ramadan education of the families and their children along with intensive monitoring of fasting children during the month is crucial.