Author : Alawadi Fatheya
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis Attitudes, Behavior and Impact of Ramadan Focused Patient Education in High-risk Groups with Dm During Ramadan Fasting by : Alawadi Fatheya
Download or read book Attitudes, Behavior and Impact of Ramadan Focused Patient Education in High-risk Groups with Dm During Ramadan Fasting written by Alawadi Fatheya and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background:Management of diabetes during Ramadan fasting can be a challenge for people with diabetes as well as for healthcare professionals. Recent studies indicates that the 94% of people with type 2 diabetes wish to fast, however, only 67% of them are able to fast the full month (1). Many of these are fasting against medical advice. Equally, the advice from healthcare professionals varies greatly from country to country. CREED study indicated that while in Algeria 83.5% of people with diabetes fasted every day, in neighboring country; Morocco only 22.9% did fast (2). This probably reflects the different advise from healthcare professionals in these two countries. Similarly, Ramadan-focused education has previously shown lower risk of hypoglycaemia during Ramadan (3). However, no previous studies have looked into the attitude, behavior and impact of Ramadan focused education in those considered as high-risk group for Ramadan fasting. Therefore, this study is the first study that includes very high/high risk category groups for fasting Ramadan and should help better understanding of diabetes and Ramadan fasting in such group. Aims:We aimed to assess the attitude and behavior as well as the impact of Ramadan focused education for very high/high risk group for fasting Ramadan. This included people with type1 diabetes, people with type2 diabetes treated with insulin, people with stable CVD and diabetes, people with CKD stage 3 and diabetes as well as women with gestational diabetes during Ramadan. METHODS: 168 person with type1 diabetes, people with type2 diabetes treated with insulin, people with stable CVD and diabetes, people with CKD stage 3 and diabetes as well as women with gestational diabetes who insisted on fasting Ramadan were recruited to the Dubai Hospital, Diabetes and Ramadan study. Our local ethics committee approved this study. All patients consented to take part in the study. They were all invited to attend a Ramadan focused patient education session. A questionnaire was applied prior to, and at the end of the educational session. 1-2 months post Ramadan the questionnaire was repeated again. Freestyle Libre CGM was provided to all patients to look into the glucose changes pre, during and immediately post Ramadan. Meanwhile, biometric (Weight, height, Blood pressure) and biochemical (Glycosylated hemoglobin-A1c, lipids profile, creatinine, and estimated glomerular filtration rate) were reported within 2 to 4 weeks before and after Results and discussion: All patients reported improved confidence in knowledge for safe fasting except for the GDM group where this reduced from pre-session value of 92% to post session level of 70%. The educational benefit of the educational session was reported at 93%. The overall average fasting days of the whole group was 27.7 days ranging from 24.1 days in type1 diabates to 29.6 in GDM. Fasting for the full moth of Ramadan was achieved by 64% of this high-risk group, which matches that achieved in by the overall diabetes community reported in CREED study (2). This average rate of fasting varied from as low as 21% in type1 diabetes to 85% in those with diabetes and stable CVD. On the contrary, change in medication was practiced by 63% of type1 patients compared to 26% in diabetes and stable CVD. This might reflect the type of treatment used. Hypoglycaemia measured by CGM data increased from 44% pre-Ramadan to 60% during Ramadan. Breaking fasting when hypoglycaemic was practiced by 85% of the overall cohort which higher than previous data from the same region few years ago (4) and might reflect the impact of Ramadan focused education as well as the availability of CGM data. On the other hand, this still indicates that 15% are not breaking the fast when their results indicate blood glucose level