Endocrine Abstracts

JOINT1988

Background: Time in tight range (TITR) is a novel glycemic metric assessing normoglycemia in individuals with diabetes.

Aim: To assess the attainability of the TITR (70–140 mg/dL) target in youth with diabetes using different treatment strategies during Ramadan fasting.

Methods: This prospective study included 276 non-insulin-treated type 2 diabetes mellitus (T2DM) and 426 patients with type 1 diabetes mellitus (T1DM) who were categorized into: multiple daily injections [MDI] + intermittently scanned CGM (isCGM), sensor augmented pump (SAP) and advanced hybrid closed loop (AHCL).

Results: At the end of Ramadan, the mean TITR was 42. 3 ± 6. 6% for all T1DM patients and 63. 5 ± 4. 0% in T2DM (P < 0. 001). The highest TITR was in T2DM group together with T1DM on AHCL (62. 3 ± 11. 6%), followed by SAP group (37. 7 ± 5. 7%) and MDI + isCGM group (23. 6 ± 5. 9%, P < 0. 001). Hypoglycemic episodes as shown by time below range (TBR) <70 mg/dL and TBR <54 mg/dL were minimal during Ramadan in AHCL group in comparison to before Ramadan (2. 6 ± 0. 7 vs 2. 9 ± 0. 9%; P = 0. 061 and 0. 4 ± 0. 1 vs 0. 5 ± 0. 1%, P = 0. 561, respectively) with a lower coefficient of variation (CoV) (P < 0. 001) than other T1DM participants.

Conclusion: At the end of Ramadan, TITR was decreased in patients with T1DM except those using AHCL who had similar levels to non-insulin-treated T2DM patients. Advanced technology has the potential for achieving tight glycemic targets, along with a reduction in CoV, without increasing hypoglycemic risk compared with other insulin treatment modalities.