Introduction and Objective: Ramadan fasting alters meal timing and circadian glucose regulation, posing challenges for individuals with type 2 diabetes (T2D). This study evaluated the impact of Ramadan fasting on glycemic variability and overall glycemic control in adults with T2D using continuous glucose monitoring (CGM) and compared outcomes with self-monitoring of blood glucose (SMBG). Methods: This prospective pilot study recruited adults with T2D treated with oral agents and/or basal insulin who fasted during Ramadan (Figure 1). Outcomes included time in range (TIR), time above range (TAR), time below range (TBR), coefficient of variation (CV), mean amplitude of glycemic excursions (MAGE), standard deviation (SD), and glycemic risk index (GRI). HbA1c was measured before and after Ramadan. Results: Thirty-four adults completed the study (mean age 57.8 ± 9.1 years; baseline HbA1c 7.7 ± 1.8%). HbA1c and glucose management indicator (GMI) decreased significantly after Ramadan (−0.6%, p = 0.006; −1.1%, p = 0.048). TIR did not differ between CGM and SMBG during the first two weeks (72% vs. 75%, p = 0.49). Participants switching from SMBG to open CGM had a 5% increase in TIR (75% versus 80% p = 0.35). CV and MAGE were similar between groups. Conclusion: CGM use during Ramadan fasting in adults with T2D was associated with improved glycemic metrics, but differences versus SMBG were not statistically significant, likely due to small sample size. Disclosure A. Abusalem: None. I.I. Brema: None. M. Almehthel: Other - Advisory panel, speakers, research support; Current; Abbott, Novo Nordisk, Sanofi. Other - advisor and speaker; Ended; Insulet Corporation. Other - advisor and speaker; Current; Amgen Inc. Advisory Panel; Ended; Vertex Pharmaceuticals Incorporated. Other - adviser and speaker; Current; AstraZeneca. Speaker's Bureau; Ended; Lilly, Novartis Pharmaceuticals Corporation. Other - advisor, speaker and research support; Current; Dexcom, Inc.
ABUSALEM et al. (Fri,) studied this question.