616-P: Self-Reported Fasting Habits in Patients with Type 1 Diabetes Mellitus

Introduction & Objective: Although intermittent fasting (IF) has increased in popularity for weight loss, it’s unknown whether patients with Type 1 diabetes (T1DM) engage in IF. Roughly 60% of patients with T1DM are overweight or obese, but are generally not encouraged to fast due to concerns about hypoglycemia or ketoacidosis. We inquired about self-reported IF among patients with T1DM.

Methods: This was a REDCAP survey administered through the EPIC-based Electronic Health Record (EHR) at the University of Minnesota/Fairview Health System from Sept-Oct 2023. This was an anonymous, voluntary survey, sent through the EHR myChart system, to patients with T1DM, ages 18-89 years old. The survey asked about IF habits and if affirmative, inquired further on their fasting habits and impact on T1DM management.

Results: Surveys went out to 1551 patients. Of the 105 respondents, 28 (26.7%) reported IF. These patients [17F and 11M: mean(SD): age 42.8 (10.9) years, BMI: 27.9 (5.6) kg/m², duration of T1DM diagnosis 23.3 (15.0) years] engaged in IF for an average of 40 months (SD=33.3). Of these patients, 5 engaged in IF (eat less/fast a few days per week) and 24 engaged in time-restricted eating [daily eating window 8.56 hours (2.8) - patients choice could overlap]. Self-reported average weight loss was 5.7 kg (SD=7.1) and only 3 used GLP-1s agonists. Four (14.3%) reported hypoglycemia related to fasting of which insulin adjustment, primarily basal reduction, was needed in 10 patients (55%). All patients wore a continuous glucose monitor (CGM), and 21 patients (75%) used an insulin pump. Overall satisfaction with IF was high, with 18 (64%) recommending it to friends/family and 21 (75%) recommending it to other T1DM patients. There were no self-reported cases of DKA in this population.

Conclusion: IF remains rare among patients with T1DM, but among those who participate, satisfaction was high. IF could be considered within the context of CGM usage, with monitoring for hypoglycemia and insulin adjustment as needed, in patients with T1DM who are overweight.