Assessment of Different Insulin Protocols Therapy in Fasting Adolescents with Type 1 Diabetes Mellitus

Abstract

D iabetes mellitus type 1 is a multisystem disease with both biochemical and anatomical \ structural consequences. It is a chronic disease of carbohydrate, fat and protein metabolism caused by the lack of insulin, which results from the marked and progressive instability of the pancreas to secrete insulin because of the autoimmune destruction of the beta cells. The bulk of literature indicates that fasting in Ramadan is safe for the majority of diabetic patients with proper education and diabetic management. Ramadan focused patient should focus on pre-Ramadan evaluation, risk stratification, and reminder about the generous religious exemptions available for deserving individuals. Those who are medically fit to fast need to be educated about the importance of a balanced nutritious diet, moderate physical exercise, adherence to the advise drugs and medications, self-monitoring of their glycemic status, early recognition of dangerous situations, and insulin dosage adjustments. In view of these data, this study aimed to evaluate the effect of fasting on the metabolic parameters (mean blood glucose, glycosylated hemoglobin, lipid profile and frequency of hypoglycemia and hyperglycemia) and its effect of fasting on body mass index and body weight in adolescents with type1 diabetes mellitus. Also to compare the effectiveness of different insulin protocols during Ramadan fasting in type 1 diabetes mellitus. The study was conducted in the specialized pediatric Diabetes clinic, Children s’Hospital, Ain Shams University in the period between May 2012 till August 2012. It included 60 children and adolescents with type1 diabetes mellitus, who were regularly followed up in the clinic, they were 19 males and 41 females, their ages ranged from 11-18 years with mean age 14.8+-2.1 years and their disease duration ranged from 1-14years.