Download PDF
CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2022; 05(02): 061-064
DOI: 10.1055/s-0042-1753496
Original Article

Comparison between Insulin Glargine and Insulin Detemir in Adolescents with Type 1 Diabetes during Ramadan Fasting

Walid Kaplan
1   Department of Pediatric, Tawam Hospital, Al Ain, United Arab Emirates
,
Bachar Afandi 
2   Department of Medicine, Tawam Hospital, Al Ain, United Arab Emirates
,
Noura Al Hassani 
1   Department of Pediatric, Tawam Hospital, Al Ain, United Arab Emirates
› Author Affiliations Funding and Sponsorship None.
› Further Information
   Permissions and Reprints

Abstract

Objectives The aim of this study was to compare between insulin glargine and insulin detemir on glucose profile in adolescents with type 1 diabetes mellitus (T1DM) who fast the month of Ramadan.

Materials and Methods This was prospective, cross-over study. Subjects were randomized into Group G, in which insulin glargine was given once daily, and Group D, in which ⅔ of the total dose of insulin detemir was given before breaking the fast and ⅓ before starting it. Subjects were crossed-over after 1 week. We compared the mean interstitial glucose (IG), and the percentages of hypoglycemia (<70mg/dL) and severe hyperglycemia (>300mg/dL) between the groups.

Results A total of 11 adolescents were enrolled. Mean (±standard deviation) age was 14±3.3 years. There was no difference in the mean IG (190±46 vs. 198±37mg/dL, p=0.1), or the percentages of severe hyperglycemia (13.5±12.9% vs. 13.6±9.2%, p=0.5) in group G and Group D, respectively. Conversely, the percentage of hypoglycemia was higher in Group G than Group D (9.1±7.0% vs. 4.4±2.7%, respectively, p=0.01).

Conclusion Insulin detemir given twice daily results in less hypoglycemia than once daily insulin glargine in adolescents with T1DM during fasting in Ramadan.

Keywords

adolescents - detemir - glargine - Ramadan fasting

Author's Contribution

All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.


Compliance with Ethical Principles

The study complies with all relevant national regulations and institutional policies, and was reviewed and approved by our regional Institutional Review Board, reference number CRD IRR # 459/16.




Publication History

Article published online:
13 September 2022

© 2022. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Al-Arouj M, Bouguerra R, Buse J. et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 2005; 28 (09) 2305-2311
    CrossrefPubMedGoogle Scholar
  • 2 International Diabetes Federation and DAR International Alliance. Diabetes and Ramadan: Practical Guidelines. Brussels, Belgium: International Diabetes Federation, 2021. www.idf.org/guidelines/diabetes-in-ramadan. Accessed June 27, 2022 and www.daralliance.org
    Google Scholar
  • 3 Afandi B, Kaplan W, Al Kuwaiti F, Al Dahmani K, Nagelkerke NJ. Ramadan challenges: fasting against medical advice. J Fasting Health 2017; 5: 133-137
    Google Scholar
  • 4 Salti I, Bénard E, Detournay B. et al; EPIDIAR study group. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 2004; 27 (10) 2306-2311
    CrossrefPubMedGoogle Scholar
  • 5 Schober E, Schoenle E, Van Dyk J, Wernicke-Panten K. Pediatric Study Group of Insulin Glargine. Comparative trial between insulin glargine and NPH insulin in children and adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2002; 15 (04) 369-376
    CrossrefPubMedGoogle Scholar
  • 6 Ibrahim M, Abu Al Magd M, Annabi FA. et al; on behalf of the International Group for Diabetes and Ramadan (IGDR). Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Res Care 2015; 3 (01) e000108 DOI: 10.1136/bmjdrc-2015-000108.
    CrossrefPubMedGoogle Scholar
  • 7 Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2018; 42 (Suppl. 01) S1-S325
    PubMedGoogle Scholar
  • 8 Afandi B, Kaplan W, Majd L, Roubi S. Rate, timing, and severity of hypoglycemia in adolescents with type 1 diabetes during Ramadan fasting: a study with Free Style Libre flash glucose monitoring system. Ibnosina J Med Biomed Sci 2018; 10: 9-11
    Article in Thieme ConnectGoogle Scholar
  • 9 Lessan N, Hannoun Z, Hasan H, Barakat MT. Glucose excursions and glycaemic control during Ramadan fasting in diabetic patients: insights from continuous glucose monitoring (CGM). Diabetes Metab 2015; 41 (01) 28-36
    CrossrefPubMedGoogle Scholar
  • 10 Ahmed SH, Gallo S. Looping with do-it-yourself artificial pancreas systems during Ramadan fasting in type 1 diabetes mellitus: perspectives of a user and a physician. Diabetes Ther 2020; 11 (11) 2453-2463
    CrossrefPubMedGoogle Scholar
  • 11 https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021536s037lbl.pdf
  • 12 Porcellati F, Rossetti P, Busciantella NR. et al. Comparison of pharmacokinetics and dynamics of the long-acting insulin analogs glargine and detemir at steady state in type 1 diabetes: a double-blind, randomized, crossover study. Diabetes Care 2007; 30 (10) 2447-2452
    CrossrefPubMedGoogle Scholar
  • 13 Pieber TR, Treichel HC, Hompesch B. et al. Comparison of insulin detemir and insulin glargine in subjects with type 1 diabetes using intensive insulin therapy. Diabet Med 2007; 24 (06) 635-642
    CrossrefPubMedGoogle Scholar
  • 14 Deeb A, Al Qahtani N, Attia S, Al Suwaidi H, Nagelkerke N. Does reducing basal insulin during Ramadan fasting by children and adolescents with type 1 diabetes decrease the risk of symptomatic hypoglycemia?. Diabetes Technol Ther 2016; 18 (09) 539-542
    CrossrefPubMedGoogle Scholar
  • 15 Alamoudi R. et al. SUN-160 insulin glargine time of injection during fasting Ramadan in patients with type 1 diabetes. J Endocr Soc 2019; 3 (Suppl. 01) SUN-160
    CrossrefGoogle Scholar
  • 16 Deeb A, Elbarbary N, Smart CE. et al. ISPAD Clinical Practice Consensus Guidelines: fasting during Ramadan by young people with diabetes. Pediatr Diabetes 2020; 21 (01) 5-17
    CrossrefPubMedGoogle Scholar
  • 17 Ibrahim M, Davies MJ, Ahmad E. et al. Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus. BMJ Open Diabetes Res Care 2020; 8 (01) e001248
    CrossrefPubMedGoogle Scholar
  • 18 Bin-Abbas BS. Insulin pump therapy during Ramadan fasting in type 1 diabetic adolescents. Ann Saudi Med 2008; 28 (04) 305-306
    CrossrefPubMedGoogle Scholar
  • 19 Alamoudi R, Alsubaiee M, Alqarni A. et al. Comparison of insulin pump therapy and multiple daily injections insulin regimen in patients with type 1 diabetes during Ramadan fasting. Diabetes Technol Ther 2017; 19 (06) 349-354
    CrossrefPubMedGoogle Scholar
  • 20 Al-Agha AE, Kafi SE, Zain Aldeen AM, Khadwardi RH. Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan. Saudi Med J 2017; 38 (04) 366-371
    CrossrefPubMedGoogle Scholar
  • 21 Elbarbary NS. Effectiveness of the low-glucose suspend feature of insulin pump during fasting during Ramadan in type 1 diabetes mellitus. Diabetes Metab Res Rev 2016; 32 (06) 623-633
    CrossrefPubMedGoogle Scholar