Automated insulin delivery for safe fasting and exercise during Ramadan in patients with type 1 diabetes: The active fast study

<h3>Aims</h3><p dir="ltr">To evaluate the safe and effective use of the MiniMed™ 780G Advanced Hybrid Closed-Loop system (AHCLS) in adults with<u> type 1 diabetes mellitus</u> (T1DM) during <u>Ramadan fasting</u> combined with structured Moderate-Intensity Exercise (MIE) followed by the non-fasting month (Shawwal) with continued MIE. </p><h3>Methods</h3><p dir="ltr">This prospective, single-arm interventional study recruited 34 adults with T1DM using the MiniMed™ 780G. Participants performed MIE during non-fasting hours in Ramadan and continued it in Shawwal. Analyzed parameters included <u>glycemic control</u>, insulin requirements, usage of the MiniMed™ 780G system, metabolic parameters, and treatment satisfaction. </p><h3>Results</h3><p dir="ltr">Median time below range (<70 mg/dL) remained stable (1.0 %) across Ramadan and Shawwal (p = 0.39). Time in range (70–180 mg/dL) was significantly higher during Ramadan (70.5 %) than Shawwal (68.5 %, p = 0.0134), with a less median time above range(>180 mg/dL) in Ramadan (29 %) compared to Shawwal (30 %) (p = 0.0088). No severe hypoglycemia or <u>DKA</u> occurred. Participants demonstrated high treatment satisfaction and SmartGuard mode usage, with good adherence to fasting and exercise. </p><h3>Conclusions</h3><p dir="ltr">Adults with T1DM can safely fast during Ramadan and exercise using the MiniMed™ 780G to manage diabetes. Findings from this study build on the real-world evidence to enhance clinical guidelines for optimal T1DM care using advanced technology.</p><h2>Other Information</h2><p dir="ltr">Published in: Diabetes Research and Clinical Practice<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.diabres.2025.112353" target="_blank">https://dx.doi.org/10.1016/j.diabres.2025.112353</a></p>