Endocrine Abstracts

Introduction: For individuals adhering to the Islamic faith, the observance of Ramadan fasting introduces a multitude of challenges, particularly regarding patients’ non-adherence to mitigating increased risks of glycemic imbalance and associated complications. This study aimed to assess the depth of knowledge among Tunisian Muslim patients diagnosed with diabetes mellitus (DM) regarding their self-management practices while fasting during the holy month of Ramadan.

Patients and Methods: A cross-sectional and descriptive study was conducted, involving 70 patients diagnosed with diabetes mellitus, at the Endocrinology Department of Hedi Chaker Hospital in Sfax, Tunisia. The study was conducted from March 15 to the end of April 2021, targeting adult individuals with diabetes mellitus who observed fasting for at least 15 days per month. Data were collected through a questionnaire in French, comprising 76 questions, translated into Arabic, and aligned with the Tunisian consensus on the management of diabetes during Ramadan.

Results: Seventy patients were enrolled, with an average age of 55 years and a female predominance, resulting in a sex ratio (M/F) of 0.3. Eighty-six percent of patients were diagnosed with type 2 diabetes, and 41% were prescribed oral antidiabetics, predominantly metformin, used as a monotherapy in 62% of cases. The mean HbA1c was recorded at 10%. Diabetic risk stratification revealed that 22.8% of patients were classified as high risk. More than half (56%) of patients demonstrated awareness that hypoglycemia poses a significant risk, especially for younger individuals. Nineteen (27%) patients could accurately identify high-risk treatment scenarios. Sixty-four percent of respondents were aware that the pre-dawn meal (suhoor) should be consumed as late as possible. Relating to clinical practices, fifty-five (79%) patients underwent a pre-Ramadan consultation. The medical practitioner advised against fasting in 36 patients. Moreover, thirty patients (43%) were equipped with a glycemic monitoring device. Hypoglycemic events were reported in 25 (36%) patients. However, forty-seven (67%) individuals did not alter their prescribed medication regimen. A notable 33% of patients skipped the pre-dawn meal. Additionally, 53 patients (76%) refrained from engaging in regular physical activity.

Conclusions: This study underscores the importance of providing clear and practical guidance on dietary choices, glycemic control, physical exercise, and potential therapeutic adjustments for individuals with diabetes observing fasting during Ramadan.