Evidence map›Paper›PMID 40620207›Full record

ArticleDiabetes, obesity & metabolism2025

Potential benefits of hybrid closed-loop systems for managing moderate- to high-risk individuals with type 1 diabetes during Ramadan fasting.

Abdullah M Alguwaihes, Metib S Alotaibi, Hamid Alqumaidi, Mohammed A Batais, Abdullah A Alrasheed, Layla N Alnasser, Janaka Karalliedde, Sufyan Hussain

Abstract readMulticenter Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abdullah M AlguwaihesEndocrinology Unit, Internal Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.ORCID 0000-0001-5800-9970
Metib S AlotaibiUniversity Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Hamid AlqumaidiUniversity Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Mohammed A BataisDepartment of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdullah A AlrasheedUniversity Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Layla N AlnasserRoyal Commission Hospital/Health Services Program in Jubail (RCHSP-J), Jubail, Saudi Arabia.
Janaka KarallieddeDepartment of Diabetes, School of Cardiovascular, Metabolic Medicine and Sciences, King's College London.ORCID 0000-0002-2617-8320
Sufyan HussainDepartment of Diabetes, School of Cardiovascular, Metabolic Medicine and Sciences, King's College London.ORCID 0000-0001-6611-8245

Funding

UK Research and Innovation (UKRI) / Medical Research Council (MRC) MR/W030004/1
6 · The paper itself

Abstract

aimWe evaluated whether using hybrid closed-loop systems (HCL) provides a safer, more effective fasting experience compared with multiple daily injections with continuous glucose monitoring (MDI + CGM) for people with T1D at moderate-to-high risk in a real-world setting. MATERIALS AND

methodsIn this multicentre prospective study, 178 adults with T1D [HCL n = 98 (39 males 59 females); MDI + CGM n = 80 (30 males 50 females)] who chose to fast in Ramadan of 2024 were assessed for clinical and glycaemic profiles and risk stratified according to the International Diabetes Federation-Diabetes and Ramadan (IDF-DAR) criteria. The composite endpoint was completing >15 days of fasting and achieving time in range (TIR) ≥70%, with time below range (TBR) <4%.

resultsAt baseline, the MDI + CGM group was older than the HCL group (mean ± standard deviation, 29.2 ± 9.6 vs. 26.3 ± 9.4 years) (p = 0.049). Half of the HCL participants met the composite endpoint versus only 8% of MDI + CGM users (p < 0.001). Similarly, participants in the HCL group were able to complete all possible fasting days more frequently than the MDI + CGM group (p < 0.05). The use of HCL was associated with nine-fold higher odds ratio (OR) (9.4 [95% confidence intervals 3.1-28.4]) of achieving the composite endpoint.

conclusionsFor moderate-to-high risk individuals with T1D, HCL substantially improves the safety and feasibility of prolonged daytime fasting during Ramadan, outperforming MDI + CGM in achieving glycaemic and fasting targets. While the results favour HCL, causal inference is still limited, given the lack of randomization and cross-over design. Concurrently, there is a need to update current recommendations for high-risk populations and underscore the central role of advanced diabetes technology in Ramadan.

Indexed as

Diabetes Mellitus, Type 1FastingGlycemic ControlHypoglycemic AgentsInsulinInsulin Infusion SystemsAdultBlood GlucoseBlood Glucose Self-MonitoringFemaleHumansIslamMaleMiddle AgedProspective StudiesYoung AdultBlood GlucoseHypoglycemic AgentsInsulinautomated insulin deliveryfastingglycaemia risk indexhybrid closed‐loop systemsRamadantype 1 diabetes

Identifiers

PMID40620207
PMCPMC12326933

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.