High HbA1c is not a reason not to fast during Ramadan in Children, adolescents and young adults with Type 1 diabetes - An observational study in Bangladesh

Aims: Our aim was to investigate the ability, frequency of acute complications and impact on glycemic control in uncontrolled T1DM who fasted during Ramadan. Methods: 74 Patients with T1D who insisted on fasting were enrolled 1 month prior to Ramadan and given intensive education by Diabetes team on insulin dose, glucose monitoring and dietary adjustments. Patients were divided into two groups; group AHbA1c < 9%(<75 mmol/mol) and group B- HbA1c >= 9% (>= 75 mmol/mol) and different variables were compared. Results: Most of the patients fasted 58 (78.4%) for more than 15 days. There was no significant difference (p = 0.790), while comparing the breaking the fast in the two groups. Hypoglycaemia was common acute complications among them. There was no significant difference in the frequency of hypoglycaemia between two groups (P = 0.448). There was increased insulin requirement in both groups during Ramadan (p = 0.00001), with an increase in basal insulin in well controlled (from 24 to 34 units). There was significant reduction of Post Ramadan mean HbA1C in both groups [P = 0.0001)]. Conclusion: Children, adolescents and young adults with T1D with poor glycaemic control can fast safely during Ramadan with proper education and intensive monitoring. (C) 2021 Elsevier B.V. All rights reserved.