Fasting Safely with Type 1 Diabetes: A Teen's Guide

People with type 1 diabetes (T1D) face big challenges when they go without food for a long time. A recent study looked at how well automated insulin delivery (AID) systems worked during a 25-hour fast, like the one observed during Yom Kippur. The goal was to see if these systems could keep blood sugar levels steady and prevent low blood sugar or high ketone levels. The study involved 54 teens and young adults with T1D. They used different AID systems, like the MiniMed 780G, Control-IQ, or open-source systems. Some made changes to their settings, like setting a higher blood sugar target or turning on sleep mode, while others didn't change anything. After the fast, researchers compared their blood sugar and insulin levels to those after a regular overnight fast.The good news is that everyone finished the fast safely. On average, the time their blood sugar was in the target range went up from 71. 6% to 82%. There were a few cases of mild low blood sugar, mostly after the meal before the fast. The study found that people who already had low blood sugar levels more often were more likely to have low blood sugar during the fast. Participants used about 43% of their usual insulin dose during the fast. Those who used less than 30% of their usual dose had higher ketone levels at the end. This shows that even though AID systems can help with fasting, the right amount of insulin is still important. The study shows that AID systems can help people with T1D fast safely. But it's important to note that everyone's body is different. Some people might need to make changes to their settings, while others might not. Always talk to a doctor before making any big changes to your diabetes management.