The association between Ramadan, pre-Ramadan diabetes education (PRE) and metabolic parameters in people with type 2
Siham Bouchareb1, Peter P Harms2, Mohamed Hassanein3
1Amsterdam UMC location Vrije Universiteit Amsterdam, Department of General Practice, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health research institute, Personalised Medicine, and Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands.
Aims:
To assess the impact of Ramadan and pre-Ramadan diabetes education (PRE) on metabolic parameters in people with type 2 diabetes (T2D). Additionally, we described the proportion of Ramadan-related adverse events.
Methods:
A retrospective longitudinal study utilising Dutch routine primary care data from 133 people with T2D who participated in a PRE session. Linear Generalized Estimating Equations models were used to assess the association of metabolic parameters with Ramadan and PRE. We analysed free-text notes and a questionnaire to identify Ramadan-related adverse events.
Results:
Ramadan was associated with modest reductions in HbA1c (β -1.07 mmol/mol; p = 0.07), systolic blood pressure (β -1.89 mmHg; p = 0.04), weight (β -0.81 kg; p < 0.01), BMI (β -0.29 kg/m2; p < 0.01), and a slight increase in triglycerides (β 0.27 mmol/l; p = 0.04) compared to non-Ramadan periods. PRE demonstrated no significant impact on metabolic parameters. The number of medical notes regarding Ramadan was small, with the mentioning of some physical complaints and medication errors.
Conclusions:
In our study, Ramadan is associated with temporary and marginal metabolic improvements in people with T2D. A single PRE session had no substantial impact on metabolic control. Healthcare professionals should more often discuss Ramadan and medication adjustments with their patients.
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