ESPE Abstracts

Introduction: Fasting is observed throughout the day when daylight is visible, or as mentioned in the Qur'an: "Eat and drink until the white thread of dawn becomes distinct to you from the black thread of night. Although patients with type 1 diabetes are medically exempt from this obligation, many insist on fasting during Ramadan. To date, healthcare providers have given conflicting advice on the feasibility of fasting during the month of Ramadan.

Objective: Evaluate the impact of Ramadan on glycemic control and the safety of prolonged fasting in diabetic children.

Material and Methods: Descriptive cross-sectional study of 10 children followed at the pediatric service CHU Tlemcen, Algeria, with type 1 diabetes and who voluntarily intended to fast during the month of Ramadan 2024. We monitored blood glucose levels using a glucometer connected to a Glyc dz application: a platform web allows us to manage diabetes remotely.

Results: 10 children were recruited: 4 girls and 6 boys with an average age of 15 years+2 months and an average age of diabetes of 5.5 years (19 months-8 years) on basal/bolus insulin. 08 children had fasted in previous years, while two were fasting for the first time. The total duration of fasting is 16h/24h in our region, and the number of fasting days averages 28 days per month (11-30). The therapeutic adjustments were a reduction in insulin doses to three injections: 2 rapid analogues at the start of fasting and at the break up of fasting, and one slow analogue at bedtime. These adjustments were made spontaneously in half cases, and on medical advice in the other half. No episodes of severe hypoglycemia or diabetic ketoacidosis, or visits to the emergency department, were reported throughout the month. Symptomatic hypoglycemia was reported, prompting a break in fasting on 07% of days. The number of blood glucose tests per day was reduced to an average of 2.95/day versus 5/day before Ramadan, with hyperglycemia in 55% of cases, 44% within target, and hypoglycemia in 1%. At the end of the fasting month, HbA1C fell to 8.77% versus 9% before Ramadan.

Conclusion: Fasting during Ramadan is an important personal decision that should be taken by the diabetic in consultation with his or her attending physician. Diabetic children and adolescents can fast during Ramadan with frequent blood glucose monitoring, which is essential to recognize the incidence of hypoglycemia and take appropriate measures to control it.