Elbarbary NS. Effectiveness of the low-glucose suspend feature of insulin pump during fasting during Ramadan in type 1 diabetes mellitus.
Diabetes Metab Res Rev 2016;
32:623-33. [PMID:
26789012 DOI:
10.1002/dmrr.2781]
[Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 12/18/2015] [Accepted: 01/04/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND
Severe hypoglycaemia during the daytime of Ramadan fasting is a highly feared complication. In a prospective study, we investigated the effect of the low-glucose suspend (LGS) algorithm on the frequency of hypoglycaemia in adolescents with T1DM who wished to fast during Ramadan.
SUBJECTS AND METHODS
Sixty patients (19 males and 41 females, 15.6 ± 2.7 years, duration of diabetes 5.8 ± 2.9 years, pump therapy for 1.73 ± 0.99 years, used the Paradigm(®) Veo(™) System (Medtronic) and were divided into two groups: first (n=25), those who used the sensor with low-glucose suspend (LGS) feature and second (n = 35), those who used the sensor but turned off low-glucose suspend (LGS) feature.
RESULTS
A total of 2716 LGS alerts occurred, and 48.6% began in the afternoon between 4pm and 7pm. The mean duration of LGS events was 26.5 min, 38% lasted for <5 min and 5.3% lasted for 120 min. Among these episodes, the mean sensor glucose was 62.3 ± 5.96 mg/dL at LGS activation, rose to 129.8 ± 11.6 mg/dL by the end of the LGS episode (when insulin delivery was automatically resumed) and was 155.6 ± 11.1 mg/dL at 240 min. LGS usage significantly reduced area under the curve (AUC) <70, AUC <60 mg/dL (p = 0.0001) and >240 mg/dL (p = 0.006). None of the LGS-on group broke their fast versus 15 in the second group (p = 0.001). No episodes of severe hyperglycaemia or DKA were noticed in either groups.
CONCLUSIONS
Usage of low-glucose suspend (LGS) significantly reduced exposure to hypoglycaemia without compromising safety. Copyright © 2016 John Wiley & Sons, Ltd.
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