Automated Insulin Delivery Systems Are Safe During Prolonged Religious Jewish Fasting Among Adolescents and Young Adults With Type 1 Diabetes

AIMS: To evaluate the outcomes of prolonged religious Jewish fasting in individuals with type 1 diabetes using automated insulin delivery (AID) systems. METHODS: This cross-sectional, non-interventional study assessed the effects of a 25-hour Jewish fast in individuals using AID systems. Data was collected on the day of the fast, one week before, and one week after. RESULTS: The study included data from 109 fasting days involving 80 adolescents and young adults with type 1 diabetes. The mean age of participants was 17.4 ± 4.1 years; 47.5% were male, and the average duration of diabetes was 7.2 ± 4.3 years. A total of 67.6% of participants modified their AID system settings during the fasting period, with the most common modification being a change in the target glucose level. Overall, 71.5% completed the fast without complications. Fasts were primarily broken because of sensor-detected hypoglycemia. No cases of severe hypoglycemia or diabetic ketoacidosis were reported during or after the fasting period. During the fast, the mean blood glucose level was 135 ± 28.6 mg/dL, time in range (70-180 mg/dL) was 80.7%, and time spent in hypoglycemia (