SynthesisJournal of diabetes investigation2019
Safety of Ramadan fasting in young patients with type 1 diabetes: A systematic review and meta-analysis.
Synthesis in Journal of diabetes investigation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Safety of Ramadan fasting in young patients with type 1 diabetes: A systematic review and meta-analysis.Journal of diabetes investigation · 2019Pooled it
- Fasting safely during Ramadan with diabetes: clinical practice recommendations for Arab populations from the Arab Diabetes Forum (FSR-ADF).Hormones (Athens, Greece) · 2026Review
- The proportion of diabetic ketoacidosis emergencies during Ramadan fasting: a retrospective study.Frontiers in endocrinology · 2026Observational
- Article
- Assessment of the IDF-DAR Fasting Risk Assessment Tool to Predict Type 1 Diabetes-Related Complications During Ramadan in a Real-World Setting.Clinical medicine insights. Endocrinology and diabetes · 2025Article
- Altered Ramadan fasting glycemic profiles of adults with type 1 diabetes reveal strong evidence of underestimated insulin adjustments: a 3-year observational study in Arab settings.Frontiers in endocrinology · 2025Observational
- Validity of the International Diabetes Federation risk stratification score of Ramadan fasting in individuals with diabetes mellitus.Saudi medical journal · 2024Observational
- Article
- Higher HbA1c was observed in young people with diabetes who fasted during COVID-19 pandemic lockdown of 2020 Ramadan in Bangladesh - A Post Ramadan survey.Diabetes research and clinical practice · 2022Article
- Glycaemic Changes Among Children and Adolescents With Type 1 Diabetes Mellitus Before and During Ramadan Fasting Using Continuous Glucose Monitoring.Journal of the ASEAN Federation of Endocrine Societies · 2022Article
- Ramadan fasting and type 1 diabetes: on a case successfully managed with an integrated system based on predictive low-glucose suspend algorithm.Acta diabetologica · 2021Article
- Young people with type 1 diabetes on insulin pump therapy could fast safely during COVID-19 pandemic Ramadan: A telemonitoring experience in Bangladesh.Journal of diabetes investigation · 2021Article
- Ramadan fasting in people with type 1 diabetes during COVID-19 pandemic: The DaR Global survey.Diabetes research and clinical practice · 2021Article
- Type 1 diabetes mellitus in children: experience in Indonesia.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2021Review
- Impact of a Single 36 Hours Prolonged Fasting Period in Adults With Type 1 Diabetes - A Cross-Over Controlled Trial.Frontiers in endocrinology · 2021Article
- Ramadan and Diabetes: A Narrative Review and Practice Update.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Review
- Looping with Do-It-Yourself Artificial Pancreas Systems During Ramadan Fasting in Type 1 Diabetes Mellitus: Perspectives of a User and a Physician.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Article
- Ramadan and Diabetes: A Narrative Review and Practice Update.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Review
- Looping with Do-It-Yourself Artificial Pancreas Systems During Ramadan Fasting in Type 1 Diabetes Mellitus: Perspectives of a User and a Physician.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Article
- Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus.BMJ open diabetes research & care · 2020Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
AIMS/
introductionAlthough patients with type 1 diabetes are medically exempt, many insist on fasting during Ramadan. Multiple daily insulin injections (MDI), premixed insulin and continuous subcutaneous insulin infusion (CSII) are commonly used. To date, little is known about the safety of Ramadan fasting in these patients. MATERIALS AND
methodsWe pooled data from 17 observational studies involving 1,699 patients treated with either CSII or non-CSII (including premixed and MDI) regimen. The study outcomes were the frequencies of hypoglycemia, hyperglycemia and/or ketosis. Given the lack of patient-level data, separate analyses for premixed and MDI regimen were not carried out.
resultsThe CSII-treated group (n = 203) was older (22.9 ± 6.9 vs 17.8 ± 4.0 years), and had longer diabetes duration (116.7 ± 66.5 vs 74.8 ± 59.2 months) and lower glycated hemoglobin (7.8 ± 1.1% vs 9.1 ± 2.0%) at baseline than the non-CSII-treated group (n = 1,496). The non-CSII-treated group had less non-severe hypoglycemia than the CSII-treated group (22%, 95% CI 13-34 vs 35%, 95% CI 17-55). Of the non-CSII-treated group, 7.1% (95% CI 5.8-8.5) developed severe hypoglycemia, but none from the CSII-treated group did. The non-CSII-treated group was more likely to develop hyperglycemia (12%, 95% CI 3-25 vs 8.8%, 95% CI 0-31) and ketosis (2.5%, 95% CI 1.0-4.6 vs 1.6%, 95% CI 0.1-4.7), and discontinue fasting (55%, 95% CI 34-76 vs 31%, 95% CI 9-60) than the CSII-treated group.
conclusionsThe CSII regimen had lower rates of severe hypoglycemia and hyperglycemia/ketosis, but a higher rate of non-severe hyperglycemia than premixed/MDI regimens. These suggest that appropriate patient selection with regular, supervised fine-tuning of the basal insulin rate with intensive glucose monitoring might mitigate the residual hypoglycemia risk during Ramadan.
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