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Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with Type 1 diabetes mellitus who fast during Ramadan: A systematic review and meta-analysis.
Diabetes Res Clin Pract. 2019 May; 151:265-274.DR

Abstract

BACKGROUND

The benefits and risks of continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) in patients with Type 1 diabetes mellitus (T1DM) who fast during Ramadan are not known.

METHODS

Systematic review and meta-analysis of observational studies conducted in PubMed, Embase (Ovid), and the Cochrane Library. Quality of included studies was assessed using the ROBINS-I tool for risk of bias assessment and analyses were performed using RevMan version 5.1.

RESULTS

From 709 records, 306 full text studies were assessed. After exclusions, the final analysis included a total of 9 studies. Heterogeneity for outcomes was I2 = 0%. There was no significant difference for the change in glycemic control (HbA1c) between CSII and MDI (P > 0.05). There was no change in weight or the lipid profile in patients with T1DM on MDI during Ramadan. There were insufficient data to assess the impact on glucose profiles and the incidence of hypoglycemia or diabetic ketoacidosis (DKA) in patients on CSII or MDI during Ramadan.

CONCLUSIONS

Studies assessing the effect of CSII or MDI in patients with T1DM who fast during Ramadan are limited to observational studies and show no difference in the change in HbA1c, weight or lipids during Ramadan.

Authors+Show Affiliations

Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.Library Services, Weill Cornell Medicine-Qatar, Doha, Qatar.Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar; University of Manchester, Institute of Cardiovascular Medicine, Manchester, United Kingdom. Electronic address: ram2045@qatar-med.cornell.edu.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30825561

Citation

Gad, Hoda, et al. "Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Patients With Type 1 Diabetes Mellitus Who Fast During Ramadan: a Systematic Review and Meta-analysis." Diabetes Research and Clinical Practice, vol. 151, 2019, pp. 265-274.
Gad H, Al-Muhannadi H, Mussleman P, et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with Type 1 diabetes mellitus who fast during Ramadan: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;151:265-274.
Gad, H., Al-Muhannadi, H., Mussleman, P., & Malik, R. A. (2019). Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with Type 1 diabetes mellitus who fast during Ramadan: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 151, 265-274. https://doi.org/10.1016/j.diabres.2019.02.019
Gad H, et al. Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Patients With Type 1 Diabetes Mellitus Who Fast During Ramadan: a Systematic Review and Meta-analysis. Diabetes Res Clin Pract. 2019;151:265-274. PubMed PMID: 30825561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with Type 1 diabetes mellitus who fast during Ramadan: A systematic review and meta-analysis. AU - Gad,Hoda, AU - Al-Muhannadi,Hamad, AU - Mussleman,Paul, AU - Malik,Rayaz A, Y1 - 2019/02/27/ PY - 2019/01/08/received PY - 2019/02/13/revised PY - 2019/02/20/accepted PY - 2019/3/3/pubmed PY - 2019/8/14/medline PY - 2019/3/3/entrez KW - CSII KW - MDI KW - Metabolic control KW - Ramadan fasting KW - T1DM SP - 265 EP - 274 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 151 N2 - BACKGROUND: The benefits and risks of continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) in patients with Type 1 diabetes mellitus (T1DM) who fast during Ramadan are not known. METHODS: Systematic review and meta-analysis of observational studies conducted in PubMed, Embase (Ovid), and the Cochrane Library. Quality of included studies was assessed using the ROBINS-I tool for risk of bias assessment and analyses were performed using RevMan version 5.1. RESULTS: From 709 records, 306 full text studies were assessed. After exclusions, the final analysis included a total of 9 studies. Heterogeneity for outcomes was I2 = 0%. There was no significant difference for the change in glycemic control (HbA1c) between CSII and MDI (P > 0.05). There was no change in weight or the lipid profile in patients with T1DM on MDI during Ramadan. There were insufficient data to assess the impact on glucose profiles and the incidence of hypoglycemia or diabetic ketoacidosis (DKA) in patients on CSII or MDI during Ramadan. CONCLUSIONS: Studies assessing the effect of CSII or MDI in patients with T1DM who fast during Ramadan are limited to observational studies and show no difference in the change in HbA1c, weight or lipids during Ramadan. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/30825561/Continuous_subcutaneous_insulin_infusion_versus_multiple_daily_insulin_injections_in_patients_with_Type_1_diabetes_mellitus_who_fast_during_Ramadan:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(19)30025-7 DB - PRIME DP - Unbound Medicine ER -