Attitudinal determinants of fasting in type 2 diabetes mellitus patients during Ramadan.

OBJECTIVE: Fasting during Ramadan has been dissuaded by the physicians for patients of Diabetes, yet fasting being a religious issue can not be made a contraindication for those who are determined. The aim of present study was to find out whether counseling prior to Ramadan can result in successful fasting with lesser adverse events. We have also studied clinical, social and demographic factors causing attitudinal difference in patients and its effect on fasting and diabetes control. RESEARCH DESIGN AND METHODS: We recruited 96 (males 54, Females 42) Muslim patients of Type 2 Diabetes, 2-3 weeks prior to Ramadan. Patients were educated about lifestyle, diet and medications. Awareness regarding diabetes management during fasting was assessed by a scored questionnaire prior to and after Ramadan. Last year Ramadan's experiences were recorded for comparison, on a recall basis. RESULT: There was increase in post Ramadan awareness score. Average increase in awareness score was more in rural patients (1.23 +/- 3.76; n = 52) than in urban (1.09 +/- 2.01; n = 44). Average number of fasts had positive correlation with duration of Diabetes. There was significant increase (p < 0.05) in the number of fasts kept this year. Maximum increase was in the age group 40-60 year (25.74%). Fifteen days fast was completed by all patients on diet control, 81.3% patients on OHA and 35.7% on insulin. Hypertensive patients had more hypoglycemic episodes. Lesser number of tobacco addicts could fast for > 15 days. No patient needed hospitalization or emergency care.
CONCLUSION: Fasting in Type2 Diabetes patients during Ramadan can be facilitated with safer outcomes and lesser adverse events. Individual attitude is important as increases in awareness and education are not linked to specific improved end-points.