927-P: Sodium–Glucose Cotransporter 2 Inhibitors Use during Ramadan in People with Type 1 Diabetes-Observational Study

927-P: Sodium–Glucose Cotransporter 2 Inhibitors Use during Ramadan in People with Type 1 Diabetes-Observational Study

Introduction & Objective: Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent a novel class of anti-hyperglycemic agents with added benefit of renal protection. Their use in type 1 diabetes is limited. During Ramadan Muslims fast from sunset to sunrise, abstaining from both food and drin...

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Bibliographic Details
Published in:Diabetes (New York, N.Y.) Vol. 73; p. 1
Main Authors: Alozairi, Ebaa S, Irshad, Mohammad, Sojan, Litty G, Alroudhan, Dherar, Taghadom, Etab, Alkandari, Jumana
Format: Journal Article
Language:English
Published: New York American Diabetes Association 01-06-2024
Subjects:
Adverse events
Clinical trials
Dehydration
Diabetes
Diabetes mellitus (insulin dependent)
Fasting
Glucose
Glucose monitoring
Hypoglycemia
Ketoacidosis
Observational studies
Ramadan
Sodium-glucose cotransporter
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Summary:Introduction & Objective: Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent a novel class of anti-hyperglycemic agents with added benefit of renal protection. Their use in type 1 diabetes is limited. During Ramadan Muslims fast from sunset to sunrise, abstaining from both food and drink which increase the potential risk of dehydration and adverse effects. This study aimed to compare glycemic metrics and adverse events in fasting and non-fasting people with Type 1 Diabetes (T1D) using SGLT2 inhibitors during Ramadan. Methods: In this prospective observational study, twenty-five people with T1D (mean age± SD: 40.4± 10.4 years, HbA1c: 7.8%± 1.2%) were divided into fasted (n=12) and non-fasted (n=13) groups. Participants received a stable dose of SGLT2 inhibitors before fasting and using continuous glucose monitoring (CGM) device. Outcomes measured differences in percentage time spent in the target range (3.9-10 mmol/L), hypoglycemic range (<3.9 mmol/L), hyperglycemic range (>10 mmol/L), glucose variability (CV%), and diabetes ketoacidosis between groups. All people underwent structured education for the safe use of SGTL2 inhibitors. Results: The mean fasting duration was 26.2± 3.5 days (range: 18-29 days). No significant differences were observed in the target range (-8.0± 11.2% vs. -0.6± 10.3%), hyperglycemic range (8.2± 11.5% vs. 0.3± 10.7%), hypoglycemic range (-0.2 ±2.7% vs. 0.3± 10.7%) and glycemic variability (1.0± 2.6% vs. -0.5± 5.4%) between fasting and non-fasting groups using SGLT2 inhibitors. No severe hypoglycemia, diabetic ketoacidosis (DKA), or hospitalizations occurred in either group during the fasting period. Conclusions: The use of SGLT2 inhibitors in people with T1D during Ramadan fasting appears safe and well-tolerated, with no reported adverse events for people undergoing structured education. However, further clinical trials are necessary to validate these findings.
ISSN:0012-1797
1939-327X
DOI:10.2337/db24-927-P