• Users Online: 585
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Contacts Login 
ARTICLE
Year : 2012  |  Volume : 4  |  Issue : 6  |  Page : 242-248

“Targeted diabetes education” and glycemic control during ramadan fasting: An exploratory study


1 Department of Medicine, Mafraq Hospital; Center for Diabetes and Endocrinology, Sheikh Khalifa Medical City, Abu Dhabi, UAE
2 Ministry of Health, Abu Dhabi, UAE
3 Center for Diabetes and Endocrinology, Sheikh Khalifa Medical City, Abu Dhabi, UAE
4 Department of Medicine, Mafraq Hospital, Abu Dhabi, UAE

Correspondence Address:
Huda Ezzeddin Mustafa
Department of Medicine, Mafraq Hospital; Center for Diabetes and Endocrinology, Sheikh Khalifa Medical City, Abu Dhabi
UAE
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-489X.210781

Rights and Permissions

Background: Management of diabetes during Ramadan fasting may be taken as a classical example of culturallysensitive care in some parts of the world. Several medical problems face diabetic patients who choose to fast. Objectives: To evaluate the effect of a locally-designed “targeted diabetes education” initiative on glycemic control of patients who intended to fast during Ramadan. Patients and Methods: This is a prospective cohort, controlled, non-randomized study. Seventy-one patients were recruited (46 women, 25 men); 10 had type 1 diabetes and 61 had type 2 diabetes. Of these, 51 patients were allocated to the intervention group, 13 were controls; 7 dropped out of the study. The “Targeted Diabetes Education” program included 2-3 educational visits to diabetes educators and 2-3 dietary counseling sessions before, during, and after Ramadan, in addition to telephone counseling and support. Home glucose monitoring was recommended to be performed in both the preprandial and 2 hour post prandial states at least 3-6 times per week plus recording of all hypoglycemic events. There was no deliberate intensification of medication for any patient. Outcome Measures: Risk stratification of patients was conducted according to the 2005 American Diabetes Association (ADA) guidelines. Preprandial and postprandial blood glucose levels, serum fructosamine, and hypoglycaemic episodes were measured during and after Ramadan. HbA1c, body weight changes and lipid profiles were also measured before and after Ramadan fasting. Results: More than 60% of the diabetic patients who fasted during Ramadan were in the higher risk groups (very high risk category 33.8%, high risk category 29.6%). Mean fasting blood glucose was reduced by 57 mg/ dL (95% CI, 21 - 94; p=0.005) in the intervention group. Mean HbA1c was lower in the intervention group by 1.5% (95% CI, 0.5 - 2.6; p=0.007) compared with the controls. Although serum fructosamine was reduced by 0.1 mmol/L (95% CI, -0.9 - 0.8; p=0.84) in the intervention group, this was not statistically significant. Mean difference in total Background: Management of diabetes during Ramadan fasting may be taken as a classical example of culturallysensitive care in some parts of the world. Several medical problems face diabetic patients who choose to fast. Objectives: To evaluate the effect of a locally-designed “targeted diabetes education” initiative on glycemic control of patients who intended to fast during Ramadan. Patients and Methods: This is a prospective cohort, controlled, non-randomized study. Seventy-one patients were recruited (46 women, 25 men); 10 had type 1 diabetes and 61 had type 2 diabetes. Of these, 51 patients were allocated to the intervention group, 13 were controls; 7 dropped out of the study. The “Targeted Diabetes Education” program included 2-3 educational visits to diabetes educators and 2-3 dietary counseling sessions before, during, and after Ramadan, in addition to telephone counseling and support. Home glucose monitoring was recommended to be performed in both the preprandial and 2 hour post prandial states at least 3-6 times per week plus recording of all hypoglycemic events. There was no deliberate intensification of medication for any patient. Outcome Measures: Risk stratification of patients was conducted according to the 2005 American Diabetes Association (ADA) guidelines. Preprandial and postprandial blood glucose levels, serum fructosamine, and hypoglycaemic episodes were measured during and after Ramadan. HbA1c, body weight changes and lipid profiles were also measured before and after Ramadan fasting. Results: More than 60% of the diabetic patients who fasted during Ramadan were in the higher risk groups (very high risk category 33.8%, high risk category 29.6%). Mean fasting blood glucose was reduced by 57 mg/ dL (95% CI, 21 - 94; p=0.005) in the intervention group. Mean HbA1c was lower in the intervention group by 1.5% (95% CI, 0.5 - 2.6; p=0.007) compared with the controls. Although serum fructosamine was reduced by 0.1 mmol/L (95% CI, -0.9 - 0.8; p=0.84) in the intervention group, this was not statistically significant. Mean difference in total cholesterol was 9.6 mg/dL (95% CI, -37.5 - 18.3; p=0.5) and in triglycerides 19.6 mg/dL (95% CI, -5 – 12; p=0.23) for the intervention group. Number of hypoglycemic events was significantly lower in the intervention group; 94% had no events compared to 73% in the control group. Mean difference in body weight was 0.4 kg (95% CI, -3.0 - 3.8: p=0.81). Conclusion: Targeted diabetes education is effective in achieving better glycemic control and reducing the risk of hypoglycemia in diabetic patients who fast during Ramadan. Therefore, more Muslim patients with diabetes who wish to fast during Ramadan can do this safely.


[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed449    
    Printed63    
    Emailed0    
    PDF Downloaded80    
    Comments [Add]    
    Cited by others 9    

Recommend this journal