Introduction and Objective: Fasting during Ramadan puts people with type 1 diabetes (PWT1D) at risk of dysglycemia and diabetic ketoacidosis (DKA). Recent studies have shown the clinical effectiveness of automated insulin delivery (AID) systems in PWT1D who fast during Ramadan. Here, we compare the effectiveness and safety profiles of the Medtronic 780G versus Tandem Control-IQ during Ramadan fasting.Methods: We compared the fasting experience, glycemic control, and fear of hypoglycemia (FOH) between users of Medtronic 780G (n= 82) and Tandem Control-IQ (n= 24) systems who fasted during Ramadan 2024.Results: There were no significant differences in the sociodemographics nor pre-Ramadan glycemic metrics between the Medtronic 780G and the Tandem Control-IQ users. During Ramadan, Medtronic 780G and Tandem Control-IQ users had comparable TIR (72.9% vs 74.2%, p=0.2), TAR (25.8% vs 24.7%, p=0.67), TBR (1.2% vs 1.2%, p=0.93), and GRI (29 vs 29, p=0.97). The mean number of days during which fasting was broken because of hypoglycemia was 2.17 days in the Medtronic group and 1.50 days in the Tandem group (p=0.4). Likewise, the mean number of days during which fasting was broken because of hyperglyemia was 0.29 days in the Medtronic group and 0.18 days in the Tandem group (p=0.56). The composite outcome of “breaking the fast due to diabetes ≤2 days & maintaining TIR >70% during Ramadan” was achieved by 43.9% of Medtronic users and 50.0% of Tandem users (p= 0.60). There were no significant differences in the levels of FOH between the two groups.Conclusion: Medtronic 780G and Tandem Control-IQ users had comparable glucose levels, fasting experience, and FOH during Ramadan. The use of AID, irrespective of its type, appears to mitigate the potential risks associated with fasting in PWT1D
M. Al-Sofiani: Advisory Panel; Medtronic. Speaker’s Bureau; Insulet Corporation, Abbott, Lilly Diabetes. Advisory Panel; Dexcom, Inc., Roche Diabetes Care. Speaker’s Bureau; Sanofi. Research Support; Medtronic. Speaker’s Bureau; Vitalaire. S. Alharthi: None. M. Alsuhaibani: None. M. Almehthel: Advisory Panel; Novo Nordisk. Speaker’s Bureau; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi. Speaker’s Bureau; Sanofi. Research Support; Sanofi. Speaker’s Bureau; Lilly Diabetes. Advisory Panel; Abbott. Speaker’s Bureau; Abbott. Advisory Panel; Dexcom, Inc. Speaker’s Bureau; Bayer Pharmaceuticals, Inc. T.H. Almigbal: None. A.M. Alhashem: None. H.A. Zarif: Other Relationship; Abbott, Medtronic. R. Alamoudi: None. N. Alzaman: None. A.M. Almurashi: None.
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