Insulin delivery modality and Ramadan fasting interruption, glycemic control, and fear of hypoglycemia in type 1 diabetes: a prospective, multicenter study from Saudi Arabia
Authors' conclusion
Use of AID during Ramadan fasting was associated with fasting the most days of Ramadan, best glycemic control, and the least frequent hypoglycemia avoidance behaviors. The International Diabetes Federation/Diabetes and Ramadan International Alliance risk calculator should consider a lower risk score for AID technology when used by PWT1D.
Study context
- Population
- People with T1D fasting during Ramadan, Saudi Arabia
- Participants
- 114 / 4 / 24 / 136
- Exposure
- Automated insulin delivery (AID) vs sensor augmented pump with predictive-low-glucose suspend (SAP-PLGS) vs sensor-unintegrated pump (SUP) vs multiple daily injections (MDI) + continuous glucose monitoring (CGM) during Ramadan fasting
- AIDn = 114
- SAP-PLGSn = 4
- SUPn = 24
- MDI + CGMn = 136reference
- Outcome
- Double target of fasting (broken fasting ≤ 2 days of Ramadan because of diabetes and TIR > 70%)
- Follow-up
- Ramadan
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
- AID vs MDI + CGM users 22 times likelier to achieve the double target, adjusted for age, sex, employment/insurance status, educational level and diabetes duration
- 22
Observational data: associations, not effects.
Further findings
| Outcome | AID | SAP-PLGS | SUP | MDI + CGM | P value |
|---|---|---|---|---|---|
| Mean percent TIR, pre/during Ramadan | mean 73.2/73.4 % | mean 62/65.5 % | mean 57.8/54.6 % | mean 52.1/47.4 % | |
| Glycemia Risk Index, pre/during Ramadan | 30/29 | 43/35 | 52/55 | 60/64 | |
| FOH behavior subscale scoreAID vs MDI + CGM · AID lowest, MDI highest score | 1.23 | — not stated in the abstract | — not stated in the abstract | 1.63 | P < 0.01 |
— not stated in the abstract
- Fear of hypoglycemia (FOH) score · between AID and SAP-PLGS
- P > 0.05
- Fear of hypoglycemia (FOH) score: overall FOH score did not significantly differ across the four groups
Fear of hypoglycemia (FOH) score
- Overall FOH score did not significantly differ across the four groups
Original publication
Insulin delivery modality and Ramadan fasting interruption, glycemic control, and fear of hypoglycemia in type 1 diabetes: a prospective, multicenter study from Saudi Arabia. Diabetes Res Clin Pract. Published 2 March 2026. doi:10.
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