Impact Of Ramadan Focused Education Program On Hypoglycemic Risk And Metabolic Control For Patients With Type 2 Diabetes

Loading...
Thumbnail Image
Date
2017-02
Authors
Tourkmani, Ayla Mhd. Dadou
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Ramadan fasting is associated with significant impact on glycemic control and patient safety among patients with type 2 diabetes (T2D). The burden of the problem is high in Saudi Arabia due to the high prevalence of diabetes. The risk can be aggravated by hot weather and long fasting duration during Ramadan in Saudi Arabia. Current guidelines recommend counseling and educating patients with T2D before Ramadan. Despite the higher risk among Saudi patients, based on the extensive literature review, there is lack of studies examining the impact of Ramadan education program among Saudi patients with T2D. Therefore, the aim of the study was to evaluate the impact of Ramadan Focused Education Program (RFEP) on hypoglycemia risk score and other related clinical & metabolic parameters (HbA1c, lipid profile, blood pressure, body weight and body mass index (BMI). A prospective non-randomized interventional controlled design was run on three phases: before, during and after Ramadan on 262 T2D patients at a large big family medicine center. The intervention group (n=140) received focused individualized diabetic education sessions and antidiabetic medications adjustment before and after Ramadan, while the control group (n=122) received standard diabetic care. A validated hypoglycemic score was used in both groups to assess the change of the risk. Patients were advised to adjust the dosage and timing of antidiabetic agents according to the recommendations for management of diabetes during Ramadan. Primary outcomes were post-intervention change of hypoglycemia score and HbA1c over a 6-month follow-up. Data were presented as mean ± standard deviation. HbA1c was expressed in percentage. The hypoglycemic scores before, during, and after Ramadan were 14.21±8.50, 6.36±6.17, and 5.44±5.55 in the intervention group, respectively (P<0.001) and 14.01±5.10, 13.46±5.30, and 9.27±4.65 in the control group, respectively (P<0.001). HbA1c levels were 9.79±1.89, 8.26±1.54, and 8.52±1.61 before, during, and after Ramadan in the intervention group, respectively (P<0.001), and 10.04±1.47, 9.54±1.38, and 9.59±1.79 in the control group, respectively (P<0.001). Post-Ramadan reductions of HbA1c and hypoglycemic scores were significantly higher in the intervention group (-13.0% vs -4.5%, P=0.004 for HbA1c and -61.7% vs -33.8%, P<0.001 for hypoglycemic score). Low-density lipoprotein cholesterol improved in the intervention group from 2.41±0.91 mmol/L before Ramadan to 2.28±0.68 mmol/L after Ramadan (P<0.001). No statistically significant effects were observed on blood pressure or body weight in the intervention group. Similarly, no change was observed in the control group. The findings of the current study suggested that Ramadan educational program has a positive impact with reduction of hypoglycemic risk, HbA1c, and lowdensity lipoprotein cholesterol. Therefore, it could be recommended for patients with increased risk of hypoglycemia during Ramadan fasting.
Description
Keywords
Metabolic control for patients , with Type 2 diabetes
Citation