Adjusting the basal insulin regimen of patients with type 1 diabetes mellitus receiving insulin pump therapy during the Ramadan fast: A case series in adolescents and adults

AbstractBackground: Ramadan, the ninth month of the Islamic lunar calendar, is the holy month of fasting for adolescent and adult Muslims. Observance of Ramadan is considered obligatory for every healthy adult Muslim. During this time, Muslims refrain from eating, drinking, smoking, and administering oral or parenteral medications from sunrise to sunset daily for 28 to 30 days.Case summary: We evaluated the need for changes in basal insulin regimen in 5 patients (4 males and 1 female; age range, 15-19 years) with type 1 diabetes mellitus (T1DM) who fasted during Ramadan. The patients were receiving insulin pump therapy with regular human insulin and maintained weekly visits with their endocrinologist at The Chronic Care Center (Beirut, Lebanon). They were instructed to break the fast after any episode of hypoglycemia (finger stick glucose