The effect of Ramadan focused education on patients with type 2 diabetes: A systematic review and meta-analysis

Gad, Hoda; Almuhannadi, Hamad; Purra, Hana; Mussleman, Paul; Malik, Rayaz A.

doi:10.1016/j.diabres.2020.108122

Cited by 23 publications

(18 citation statements)

References 42 publications

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“…A systematic review concluded that Ramadan focused education reduced the incidence of hypoglycaemia (6). Furthermore, in our recent systematic review and meta-analysis we showed that Ramadan-focused diabetes education leads to a decrease in Hb A1c and LDL, but an increase in triglycerides and weight during Ramadan (7). It also identified a lack of head to head studies and limited observational studies with inadequate endpoints comparing sulphonylureas (SU) with dipeptidyl peptidase-4 inhibitors (DPP-4i).…”

Section: The International Diabetes Federation (Idf) and Diabetes Andmentioning

confidence: 99%

Efficacy and safety of the newer oral hypoglycemic agents in patients with T2DM during Ramadan: A systematic review and meta-analysis

Gad

Hayat

Almuhannadi

et al. 2021

Diabetes Research and Clinical Practice

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: The International Diabetes Federation (Idf) and Diabetes Andmentioning

confidence: 99%

Efficacy and safety of the newer oral hypoglycemic agents in patients with T2DM during Ramadan: A systematic review and meta-analysis

Gad

Hayat

Almuhannadi

et al. 2021

Diabetes Research and Clinical Practice

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“…Given that many patients with diabetes observe fasting during Ramadan, glycemic control management for those patients is a critically important health challenge worldwide (7). (8)(9)(10) and metabolic (11,12) complications, the impact of patient education and pre-fasting preparation (13)(14)(15)(16)(17)(18)(19), medication adjustment and insulin dosing (14,20,21), and dietary/lifestyle modifications (21,22) during Ramadan and how these changes impact the outcomes at the end of the fasting month.…”

Section: Introductionmentioning

confidence: 99%

“…Available research has considered various aspects of fasting during Ramadan. Research topics include clinical ( 8 – 10 ) and metabolic ( 11 , 12 ) complications, the impact of patient education and pre-fasting preparation ( 13 – 19 ), medication adjustment and insulin dosing ( 14 , 20 , 21 ), and dietary/lifestyle modifications ( 21 , 22 ) during Ramadan and how these changes impact the outcomes at the end of the fasting month.…”

Section: Introductionmentioning

confidence: 99%

Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies

et al. 2021

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Ramadan is the 9th month of the lunar calendar during which Muslims abstain from food and drink between dawn and sunset for 30 consecutive days. Ramadan fasting is observed by all healthy Muslim adults, as well many Muslims with type 2 diabetes (T2DM). Hypoglycemic events (HE) are a serious complication associated with diabetes management and are associated with increased cardiovascular disease risk. Conflicting results have been reported concerning the incidence of HE among people with T2DM observing Ramadan fasting. This review summarizes available scientific evidence on the occurrence of HE and the effects of different moderators on the incidence of HE among patients with T2DM during Ramadan. We conducted a systematic review of available observational studies and randomized controlled trials (RCTs) for patients with T2DM who fasted during Ramadan, with HE as the primary outcome. Ten databases were searched for relevant studies from inception until October 31, 2020. In total, 68 studies (35 RCTs and 33 observational studies) met the inclusion criteria. Non-sulfonylureas hypoglycemic medications showed superior effects in lowering the incidence of HE over sulfonylureas hypoglycemic medications. Variable moderators were associated with experiencing HE during Ramadan in both observational studies and RCTs, including sex, geographical location, body anthropometric indicators, season, dietary behaviors, fasting duration, time since diagnosis, and pre-fasting education. This comprehensive systematic review covered the largest number of observational and clinical studies investigating the impact of Ramadan on HE among patients with T2DM. The study highlights the significance of different moderators that influence the effect of Ramadan fasting on HE, including dietary behaviors, fasting time duration, sex, season, country, pre-fasting education, age, and time since diagnosis. The study also highlighted the impact of different hypoglycemic medications on HE and noted the superiority of non-sulfonylureas over sulfonylureas hypoglycemic medications in lowering the risk for hypoglycemia in people with T2DM during Ramadan fasting.

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“…Many diabetes clinics in Muslim-majority countries, including Saudi Arabia (SA), arrange a “Pre-Ramadan” clinic visit for their patients during this time to provide diabetes education and medication adjustments prior to fasting. 30 This could not have been done this year, which further complicated matters for both patients and HCPs.…”

Section: Introductionmentioning

confidence: 99%

Rapid Implementation of a Diabetes Telemedicine Clinic During the Coronavirus Disease 2019 Outbreak: Our Protocol, Experience, and Satisfaction Reports in Saudi Arabia

Al-Sofiani

Alyusuf

Alharthi

et al. 2020

J Diabetes Sci Technol

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Background: The importance of telemedicine in diabetes care became more evident during the coronavirus disease 2019 (COVID-19) pandemic as many people with diabetes, especially those in areas without well-established telemedicine, lost access to their health care providers (HCPs) during this pandemic. Subjects and Methods: We describe a simplified protocol of a Diabetes Telemedicine Clinic that utilizes technological tools readily available to most people with diabetes and clinics around the world. We report the satisfaction of 145 patients and 14 HCPs who participated in the virtual clinic and 210 patients who attended the virtual educational sessions about “Diabetes and Ramadan.” Results: The majority of patients agreed or strongly agreed that the use of telemedicine was essential in maintaining a good glucose control during the pandemic (97%) and they would use the clinic again in the future (86%). A similar high satisfaction was reported by patients who attended the “Diabetes and Ramadan” virtual educational session and 88% of them recommended continuing this activity as a virtual session every year. Majority of the HCPs (93%) thought the clinic protocol was simple and did not require a dedicated orientation session prior to implementing. Conclusions: The simplicity of our Diabetes Telemedicine Clinic protocol and the high satisfaction reported by patients and HCPs make it a suitable model to be adopted by clinics, especially during pandemics or disasters in resource-limited settings. This clinic model can be quickly implemented and does not require technological tools other than those widely available to most people with diabetes, nowadays. We were able to successfully reduce the number of patients, HCPs, and staff physically present in the clinics during the COVID-19 pandemic without negatively impacting the patients’ nor the HCPs’ satisfaction with the visits.

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The effect of Ramadan focused education on patients with type 2 diabetes: A systematic review and meta-analysis

Cited by 23 publications

References 42 publications

Efficacy and safety of the newer oral hypoglycemic agents in patients with T2DM during Ramadan: A systematic review and meta-analysis

Efficacy and safety of the newer oral hypoglycemic agents in patients with T2DM during Ramadan: A systematic review and meta-analysis

Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies

Rapid Implementation of a Diabetes Telemedicine Clinic During the Coronavirus Disease 2019 Outbreak: Our Protocol, Experience, and Satisfaction Reports in Saudi Arabia

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