A survey of fasting practices and acceptance of an intervention for achieving control in diabetes during Ramadan

Many people with diabetes, who practise Islam, are passionate about fasting during Ramadan despite their medical condition and exemption from the religion. These patients are at risk of hypoglycaemia, hyperglycaemia, diabetic ketoacidosis, dehydration and thrombosis. We evaluated the acceptability of an individualized management plan for such people.

We conducted a survey to assess the knowledge and ability of patients to manage their diabetes while observing the fast during Ramadan. Then, the acceptance of an educational intervention was assessed among patients, which was provided 1 month before Ramadan. Patients were followed up at 2 weeks into and after Ramadan.

Of the survey population, only 14.7% of patients volunteered for pre-Ramadan assessment and 97.5% of patients recollected suffering from symptoms suggestive or hypoglycaemia or hyperglycaemia. Following the intervention, 17 of 50 patients did not fast; 26 patients followed dietary advice, while 7 patients did not. Symptoms suggestive of hypoglycaemia and hyperglycaemia were reported by 21 of 33 patients who fasted and 21 of 28 patients reported lower body weight. Insulin and hypoglycaemic drugs were changed from morning to evening dosing in 41% of patients while 18% of patients had their drugs stopped.

An educational intervention generated awareness among the patients and helped 43 of 50 patients in making rational decisions about control of diabetes during Ramadan.