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The Outcomes of Type 2 Diabetes Education Before Ramadan

Educating patients about diabetes management during Ramadan can potentially increase health outcomes…

One of the five pillars of Islam is Ramadan. During Ramadan, Muslims refrain from eating, drinking, using oral and injectable medications, and smoking from before dawn until after sunset. The American Diabetes Association (ADA) published a report in September 2005 stating that people with type 1 diabetes and women who are pregnant should refrain from fasting because of the increased risk of developing life-threatening acute metabolic complications. Type 2 diabetics who want to engage in Ramadan should receive a full clinical assessment prior to engaging in any activities. After the report was published by the ADA, two articles have been published. One study reported that Ramadan was associated with significant weight loss and a decrease in the amount of hypoglycemic scenarios. The other study states that Ramadan can improve A1c significantly if adjustments are created to patients’ antidiabetic routine.

The purpose of this study was to observe the effects of individualized pre-Ramadan education and improvement of clinical events and a safer fast for patients with type 2 diabetes. The pre-Ramadan education was designed into an education program that discussed topics about meal planning, physical exercise, and blood glucose monitoring. This study was designed as a multinational, multicenter, prospective observational study at a clinic level. The study consisted of 774 patients with type 2 diabetes who attended clinics in Egypt, Iran, Jordan and Saudi Arabia and fasted for 2 or more days during the 2014 Ramadan. For the intervention proportion of the study, patients received 30 minutes to an hour of face-to-face individualized time with a dietitian, specialist nurse, or community link worker. In this study, continuous variables such as baseline characteristics were analyzed using Chi-square test or Fischer exact test.

The results show that patients who received one-to-one education had an increased probability of changing their diabetes treatment during Ramadan (97% vs 88%, p<0.0001). Also patients who received one-to-one education were more likely to complete self-monitoring of blood glucose twice daily throughout Ramadan (70% vs 51%, p<0.0001). The individualized educated patients had an improved comprehension about hypoglycemic signs and symptoms as well (p=0.0007).

The researchers concluded that incorporating individualized education programs in the clinics prior to Ramadan can be accomplished and that patients showed better weight management and A1c control.

Practice Pearls:

  • A safer fast during Ramadan can be accomplished for diabetic patients through proper educational programs.
  • Individualized education and diabetes treatment management program is a great tool to aid diabetes lose weight.
  • Educational program tailored to a particular diabetic patient can lead to improvement in glycemic control.

Mcewen LN, Ibrahim M, Ali NM, et al. Impact of an individualized type 2 diabetes education program on clinical outcomes during Ramadan. BMJ Open Diabetes Res Care. 2015;3(1):e000111.