Pre-Ramadan Counseling Among Type Two Diabetic Patients Who Decided to Fast Ramadan

Abstract

Background: Ramadhan is the fasting month among the Muslim population, and fasting is one of the five pillars of the Islamic religion. During Ramadhan, there is a major change in the meal times, which significantly affects the body's metabolism and hydration status, increasing the risk of hyper and hypoglycemia in diabetic patients. Probably Pre-Ramadan counseling will improve the rate of these complications. Patients and methods: This is a prospective cross-sectional study, which included 307 Muslim patients with type 2 diabetes mellitus who decided to fast Ramadan during 2019 in two cities in the Kurdistan region of Iraq. Participants were categorized based on whether they had pre-Ramadan counseling or not. Results: The mean age of our patients was 55.24, and 71% of patients were females; the mean duration of diabetes mellitus was 80.76 months. Most patients enrolled in this study fasted the whole month (the mean was 26.86 days). Less than 20% had pre-Ramadhan counseling. The majority of patients were not ready to break the fasting (61.6%). Hypoglycemic attacks were less common in patients who had undergone pre-Ramadan counseling (p-value 0.006). There was also no significant correlation of pre-Ramadan counseling with the level of HbA1c (p-value 0.401); however, there was a significant correlation of pre-Ramadan counseling with both serum cholesterol, serum LDL, and hypoglycemic attacks (p values 0.13, 0.002, and 0.006), respectively, with no any significant correlation with triglycerides and HDL levels (p values 0.687 and 0.698) respectively. Conclusion: Pre-Ramadan counseling is very vital for diabetic patients who decided to fast Ramadan. Pre-Ramadan counseling is a good tool to inform patients about if they are fit to fast or not, the likelihood of complications during Ramadan, and how to manage them (principles of self-management). We recommend a structured diabetes education to decrease the attacks of hypoglycemia. A patient will know when to monitor his/her blood sugar and when to breakfasting. Will know when to exercise, when to monitor his/her blood sugar and when to breakfasting.