Knowledge of diabetes mellitus and safe practices during Ramadan fasting among Muslim patients with diabetes mellitus in Singapore

Abstract

INTRODUCTIONThis study aimed to explore the level of knowledge of Muslim patients with diabetes mellitus (DM) regarding DM and the self-management of DM when fasting during Ramadan. METHODSMuslim patients with DM attending the Diabetes Centre of Singapore General Hospital, Singapore, were surveyed on their knowledge of DM and self-management of DM when fasting during Ramadan. Data on patient demographics, DM history and management of DM during the previous Ramadan was also collected. RESULTS A total of 92 patients (34 male, 58 female) were surveyed. The mean age of the patients was 53.4 ± 13.3 years.The patients were either Malay (91.3%) or Indian (8.7%), and most (66.3%) had at least a secondary school education. Most (89.1%) had Type 2 DM. The mean duration of DM was 8.7 ± 5.1 years and mean pre-Ramadan haemoglobin A1c was 8.4% ± 1.8%. DM treatment consisted of insulin therapy (37.0%), oral glucose-lowering drugs (35.9%) and combined therapy (22.8%). The mean DM knowledge score was 58.8% for general knowledge and 75.9% for fasting knowledge. During the previous Ramadan, although 71.4% of the patients consulted their physicians, 37.3% did not monitor their blood glucose levels and 47.0% had hypoglycaemic episodes. Among those who had hypoglycaemia, 10.8% continued to fast.CONCLUSION Unsafe self-management practices were observed among DM patients who fasted during Ramadan. Efforts should be made to bridge the gap between knowledge of DM and self-management of DM.

Development of a diabetes‐related nutrition knowledge questionnaire for individuals with type 2 diabetes mellitus in Singapore

“…Based on the literature review on diabetes self‐care and nutrition questionnaires at Stage 1, 68 questions were generated. After deliberation by the expert panel (details as mentioned earlier), it was decided that the first draft of the DRNK‐Q would consist of four sections: (1) Food portion and sizes , (2) Nutrition content of foods , (3) Healthier food choices and safety and (4) Food label reading , comprising a total of 59 questions, modified to suit the local context; the scoring system was as mentioned in Section 2.…”

“…There are currently three commonly used tools to assess diabetes self‐care knowledge. The first is the Diabetes Knowledge Test (DKT) to measure the diabetes self‐care knowledge of adult patients with type 1 diabetes mellitus (T1DM) or T2DM, validated for Malaysia and Singapore . However, 19 out of 23 items within the DKT are not related to diet and nutrition, hence precluding adequate assessment of DRNK.…”

“…The first is the Diabetes Knowledge Test (DKT) to measure the diabetes self-care knowledge of adult patients with type 1 diabetes mellitus (T1DM) or T2DM, [7][8][9] validated for Malaysia and Singapore. 10,11 However, 19 out of 23 items within the DKT are not related to diet and nutrition, hence precluding adequate assessment of DRNK. The second is the Diabetes Knowledge Assessment, which comprehensively assesses T2DM patients' level of understanding of diabetic complications, hyperglycaemia, hypoglycaemia, urine testing, and nutrition, but only contains five questions related to diet and nutrition.…”

Clinical and Metabolic Effects of Ramadan Fasting among A Sample of Diabetic Patients Attending Qualubeya Governorate Hospitals

“…The mean age of the examinee was 56.5±9.5 years which is like examination led in Oman in which the mean age was 54.3 ± 11.7. 14 In the current study 66% of the study sample of patients did not screen their blood glucose, which is a lot higher than detailed in Singapore where 37.3% of patients announced that they didn't screen their blood glucose 19 , observing blood glucose enables the patients to successfully self-oversee themselves, recognize and avoid scenes of hypoglycemia and hyperglycemia. In this study the level of patients who counseled a doctor previously to Ramadan fasting was 19.0 which is less than made reference to in Pakistan as 33.3% of patients counseled doctors pre Ramadan fasting.…”

Factors Associated with Successful Fasting among Type 2 Diabetic Mellitus Patients during Ramadan: A Retrospective Recall Study

“…Although 89.3% of patient change their medication regime during Ramadan (Yaacob et al 2007), only 38.1-62.7% do SMBG during Ramadan (Zainudin et al 2017;Tan et al 2018 ), and 47% of patients had experience hypoglycaemia during fasting, out of which, 10.8% had continued to fast (Zainudin et al 2017). Many DM patients (24-82%) lacked knowledge on safe Ramadan fasting (Yaacob et al 2007;Zainudin et al 2017;Tan et al 2018). Regarding diet practice, 40-58% considered sugary food as acceptable during breaking fast (Yaacob et al 2007;Zainudin et al 2017).…”