Looping with Do-It-Yourself Artificial Pancreas Systems During Ramadan Fasting in Type 1 Diabetes Mellitus: Perspectives
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COMMENTARY
Looping with Do-It-Yourself Artificial Pancreas Systems During Ramadan Fasting in Type 1 Diabetes Mellitus: Perspectives of a User and a Physician Syed Haris Ahmed
. Saira Gallo
Received: July 21, 2020 The Author(s) 2020
ABSTRACT Hybrid closed-loop automated insulin delivery systems have helped type 1 diabetes (T1D) users close the loop between glucose monitoring and insulin delivery, a very important step in efforts to simulate the glucose-responsive insulin secretory function of a healthy pancreas. Do-ItYourself Artificial Pancreas Systems (DIY APS) are a form of hybrid closed-loop system that use open-source algorithms, which govern the delivery of insulin in response to interstitial
glucose and other variables that are personalized to an individual. The flexibility and customization afforded by these systems make them amenable for use in different worldly circumstances, one of which is fasting during the annual occurrence of Ramadan for observant Muslims. Here, we present the views of a DIY APS user who was able to fast successfully on most days of Ramadan after adopting this system, and the overview of a physician on these systems, with a focus on fasting during Ramadan with T1D.
Keywords: Artificial pancreas systems; Do-ityourself; Hybrid closed-loop systems; Iftaar; Looping; Ramadan; Suhoor; Time-in-range; Type 1 diabetes; #WeAreNotWaiting
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12727640. S. H. Ahmed (&) Department of Endocrinology and Metabolic Medicine, Countess of Chester Hospital NHS Foundation Trust, Chester, UK e-mail: [email protected] S. H. Ahmed School of Medicine, University of Liverpool, Liverpool, UK S. Gallo Tustin, California, USA
Diabetes Ther
Key Summary Points Observing Ramadan fasting is an important pillar of faith and hence holds deep spiritual value for practicing Muslims. However Type 1 diabetes patients are risk stratified as being at high risk, because of the potential for acute complications and hence advised not to fast. In this commentary, a Type 1 diabetes patient shares her experience of using a Do-It-Yourself Artificial Pancreas System (DIY APS), to manage her diabetes during Ramadan fasting. Her quality of life and ability to self-manage diabetes were greatly enhanced by this open source technology. DIY APS, a brainchild of the #WeAreNotWaiting community, has the flexibility and customizability that are required for a fasting Type 1 patient; hence these systems are a therapeutic option for patients who choose to fast for religious or personal reasons. Further research would help regulatory bodies develop a framework and guidance, for health care professionals to support DIY APS users.
A T1D USER PERSPECTIVE I was diagnosed with type 1 diabetes in early 1996, when I was 8 years old and living in Pakistan. When I woke up from my diabetic ketoacidosis (DKA) coma, one of the first things I was told was a list of the things I would never be allowed to eat again. All the kids at my school were t
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