Can J Diabetes. 2024 Mar 18:S1499-2671(24)00059-5. doi: 10.1016/j.jcjd.2024.03.003. Online ahead of print.
ABSTRACT
BACKGROUND: No data are available regarding glycemic control of patients with type 1 diabetes mellitus (T1D) during Passover.
OBJECTIVE: To assess the effect of Passover on diabetes management and glycemic control in adults with T1D with nutritional changes during Passover (observant) compared with patients who did not change their dietary habits during Passover (non-observant).
METHODS: Observational pre-post study of adult patients with T1D, followed in a diabetes clinic in Israel. Data were downloaded from insulin pumps and CGM for 37 days: 2 weeks before Passover, 9 days of Passover, and 2 weeks thereafter. Differences in percentage of time spent above target (>10.0 mmol/l and >13.9 mmol/l), at target (3.9-10.0 mmol/l) and below target (<3.9mmol/l and <3.0 mmol/l) were compared using paired t-tests or paired signed rank tests.
RESULTS: The study cohort included 43 patients (23 observant, 20 non-observant). The average BG was significantly higher during Passover compared with the period before Passover – in non-observant patients 8.2±1.5 mmol/l and 7.9±1.3 mmol/l (p=0.043), respectively, and in observant patients 8.7±1.6 mmol/l and 8.4±1.6 mmol/l (p=0.048), respectively. Time above range (TAR) 10-13.9 mmol/l was increased in observant patients during Passover, as compared to the period before Passover – 24.9±16.2% and 20.6±12.4% (p=0.04), respectively. The dose of bolus insulin had increased significantly in observant patients – 27.4±13.9 units during Passover, as compared with 24.2±11.2 units before Passover (p=0.02).
CONCLUSIONS: Passover alters glycemic control and insulin needs in Jewish patients with T1D. It is advisable to make specific adjustments to maintain the recommended glycemic control.
PMID:38508514 | DOI:10.1016/j.jcjd.2024.03.003
