Clinical Diabetology · Published 2025-09-12 · DOI 10.5603/cd.106418
OBJECTIVE: To evaluate the safety and health effects of Ramadan fasting among university students with type1 diabetes (T1D) (frequency of fasting, incidence of hypoglycemia and hyperglycemia, and impact of different insulin types on glycemic control during Ramadan). MATERIAL AND METHODS: This is a prospective observational study conducted on university students, during Ramadan 1444 Hijri (March 23–April 21, 2023). A totalof 164 students with T1D (aged 18–24 years) were recruited. Participants were monitored for fasting duration, types of insulin adjustments, glycemic fluctuations, HbA1c levels, and LDL changes. Self-monitoring of blood glucose levels was measured, then data were statistically analyzed using SPSS software. RESULTS: The study showed that fasting was generally well tolerated, with a median fasting duration of 26 days. However, glycemic fluctuations were common among participants. Hyperglycemia occurred most frequently 2 hours after Iftar (51.2%), while hypoglycemia was most prevalent before Iftar (43.3%). Participants using regular human insulin had a significantly higher risk of developing hypoglycemia compared to those using short-acting insulin analogs (OR = 1.45, 95% CI: 1.27–2.72, p = 0.007). No severe hypoglycemic episodes requiring assistance or hospitalization were reported. No significant changes were observed in HbA1c or LDL levels post-Ramadan. CONCLUSIONS: The risk of glycemic fluctuations in T1D during fasting remains high, particularly among those using regular human insulin. Standardized fasting recommendations for young adults with T1D require more research to maximize their safety and metabolic results, and pre-Ramadan education and structured insulin management regimens are essential to reducing these hazards.
Abstract from DOAJ. Public domain (CC0 1.0).
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