title: Effectiveness of the low-glucose suspend feature of insulin pump during fasting during Ramadan in type 1 diabetes mellitus.
abstract: Severe hypoglycaemia during the daytime of Ramadan fasting is a highly feared complication. In a prospective study, we investigated the effect of the low-glucose suspend (LGS) algorithm on the frequency of hypoglycaemia in adolescents with T1DM who wished to fast during Ramadan.
  
  
  
  Sixty patients (19 males and 41 females, 15.6 ± 2.7 years, duration of diabetes 5.8 ± 2.9 years, pump therapy for 1.73 ± 0.99 years, used the Paradigm(®) Veo(™) System (Medtronic) and were divided into two groups: first (n=25), those who used the sensor with low-glucose suspend (LGS) feature and second (n = 35), those who used the sensor but turned off low-glucose suspend (LGS) feature.
  
  
  
  A total of 2716 LGS alerts occurred, and 48.6% began in the afternoon between 4pm and 7pm. The mean duration of LGS events was 26.5 min, 38% lasted for <5 min and 5.3% lasted for 120 min. Among these episodes, the mean sensor glucose was 62.3 ± 5.96 mg/dL at LGS activation, rose to 129.8 ± 11.6 mg/dL by the end of the LGS episode (when insulin delivery was automatically resumed) and was 155.6 ± 11.1 mg/dL at 240 min. LGS usage significantly reduced area under the curve (AUC) <70, AUC <60 mg/dL (p = 0.0001) and >240 mg/dL (p = 0.006). None of the LGS-on group broke their fast versus 15 in the second group (p = 0.001). No episodes of severe hyperglycaemia or DKA were noticed in either groups.
  
  
  
  Usage of low-glucose suspend (LGS) significantly reduced exposure to hypoglycaemia without compromising safety. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Pediatrics, Pediatric Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Nancy Samir
authors.initials: NS
authors.lastname: Elbarbary
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D018670:Monitoring, Ambulatory; D011379:Prognosis; D011446:Prospective Studies; D012067:Religion; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Ramadan fasting; hypoglycaemia; insulin pump therapy; low-glucose suspend (LGS); type 1 diabetes