DAR-GRACE: Diabetes and Ramadan: glycaemic control, physician counselling and patient practices –experience from a tertiary care hospital in Pakistan

Abstract

Objective: To identify patient practices and knowledge pertaining to Ramadan fasting and to see whether physicians were
providing adequate counselling and adjusting medications accordingly.
Methods: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from June to August 2018, and comprised diabetic patients who fasted during Ramadan. A questionnaire was designed to assess patients’ knowledge, risk category, pre-Ramadan counselling, medication adjustment, lifestyle changes, pre- and post- Ramadan glycated haemoglobin levels, and complications during Ramadan. Data was analysed using SPSS 23.

Results: Out of 272 diabetics, 176(64.7%) were females. Mean number of fasts kept were 22±10.61. Pre-Ramadan 120(44.1%)
patients consulted their physicians and 105(87.5%) of them received relevant counselling. Medications were adjusted in
only 30 (25%) such cases. Overall, 41(15.1%) patients were in the high-risk category, while 109(40.1%) and 122(44.9%) were
in the moderate and low-risk categories. During the month, 17(6.25%) were hospitalised due to diabetes-related
complications. Glycated haemoglobin levels fell significantly (p<0.0001).
Conclusion: Anomalous patient behaviours and suboptimal physician practices were noticed.
Keywords: Diabetes; Ramadan; Pakistan