The effect of Ramadan focused education on patients with type 2 diabetes: About a tertiary center experience

Abstract

Background: Diabetes is a major public health problem worldwide, it will be the 7th leading cause of death in the world in 10 years. However, fasting, which is one of the pillars of our Muslim religion, represents a major challenge for people with diabetes mellitus, predisposing them to several risk such as hypoglycemia, hyperglycemia and dehydration,hence the need for good therapeutic education and support for diabetic patients to ensure a fast without incidents. Objective: The objective of this work is to describe the therapeutic education and support program for type 2 diabetic patients during the month of Ramadan, and the evaluation of the impact of this program on the management of diabetic patients during this month. Materials and methods: The study is a prospective cross-sectional study over a period of 3 months from April 2019 to July 2019, involving 176 type 2 diabetic patients followed at the endocrinology department of Mohammed VI University Hospital in Marrakech or referred from the general medicine consultation, and who have benefited from the therapeutic education program including an interview, a clinical examination, a biological assessment, a cardiology consultation, an ophthalmology consultation, an impedancemetry analysis and an educational session. Results: Our series includes a total of 176 patients, 72.7% of whom are women and 27.3% are men, with an average age of 58 years. The majority of the patients are out of school with an average duration of type 2 diabetes of 8 years. The most frequent comorbidity is hypertension, with a mean HBA1C of 9.3% for all patients. Patient management was based on drug therapy, 11 patients were treated with dietary hygiene measures, 98 patient with ADO, 40 patients with insulin therapy, 26 with combined ADO and Insulin and 1 with GLP-1 analogue. Among the complications of diabetes detected, 40 patients had evidence of diabetic retinopathy. After risk stratification, 81 patients were authorized to fast, while 95 patients were classified as non-fasting patients. After Ramadan, the patients in our study were summoned, the fasting patients improved their blood sugar control, the occurrence of hypoglycemic episodes was observed in 25% of the patients, the majority of which managed their hypoglycemia well, while fasting blood sugar control was respected in the majority of patients. 67% of non-fasting patients complied with the decision to prohibit fasting. However, all patients reported that they found the therapeutic education pathway useful.