Introduction and Objective: Automated insulin delivery (AID) systems adjust insulin delivery based on real-time glucose readings, offering potential advantages over open-loop insulin delivery (OLID). Ramadan fasting presents unique challenge for individuals with type 1 diabetes (T1D) due to significant fluctuations in glucose levels. This study aimed to identify the predictor factors associated with achieving better Time In Range (TIR) during Ramadan fasting among individuals living with T1D using AID systems.Methods: We conducted a dual-center, open-label, randomized controlled trial with T1D patients using OLID (Medtronic MiniMed 640G or MiniMed VEO insulin pumps with Guardian 3/4 sensors or Freestyle Libre sensors) who observed Ramadan fasting. Participants were randomly assigned to either an AID system (Medtronic MiniMed 780G SmartGuard or Tandem T-slim Control IQ) or continued with OLID.Results: Baseline characteristics were similar between groups. The control group (N=55) had an average age of 27.7 ± 6.0 years, while the intervention group (N=44) had an average age of 26.6 ± 7.8 years. Females comprised 65% of the control group and 63% of the intervention group. The intervention group achieved a mean TIR of 72.6%, a Time Below Range (TBR) of 1.4%, and a Time Above Range (TAR) of 26%, compared to 55.8%, 3.2%, and 41%, respectively, in the control group (p<0.001 for all comparisons). We performed a logistic regression analysis to explore the predictor factors for changes in TIR. The only variable that predicted changes in TIR was the change in fructosamine levels (beta value -0.3 ± 0.1, p value 0.031). Other factors such as age, sex. baseline HbA1c, baseline weight, and duration of diabetes, did not predict changes in TIR in this cohort.Conclusion: For individuals with T1D using AID systems during Ramadan fasting, changes in fructosamine levels were the only factor that predicted variations in TIR.
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. A. Alqahtani: None. N. Aboalsamh: None. I. Brema: None. M.M. Ahmad: None. A.E. Aljohani: None. N.A. Sharahili: None. S.H. Alzahrani: None. I.A. Alghofaili: None. M. Hassanein: None.
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