Abstract
Objectives: The objective of this study is to assess health difficulties facing diabetic patients in fasting during Ramadan, at a hospital based primary care clinic, Riyadh, Saudi Arabia.
Methods: This is a cross sectional study which was conducted at a hospital based primary care clinic at King Khalid University Hospital(KKUH), in Riyadh, Saudi Arabia. The study was conducted over a 5 month period started immediately after Ramadan 1427 (from 9th of Shawal 1427 to the end of Safar 1428) 31 October 2006 till 10 march 2007.
All adult male diabetic patients attending a one consultant primary care clinic at KKUH were interviewed during their routine follow up consultation by a consultant in family medicine. All included diabetic patients were interviewed once by the same consultant in family medicine. All diabetic patients were asked to determine how many days already they fasted during Ramadan 1427, any hypoglycemic attacks during Ramadan. They were also asked to categorize difficulties in fasting during Ramadan as: no difficulty, sometimes, and always. Patients were also asked did they adjust their diabetic medications and did they receive particular health education about adjusting their diabetic treatment during Ramadan. Data was analyzed using the statistical package for social science (SPSS) version 11.5.
Results: A total of 204 adult male diabetic patients were included in the study. Majority of patients were type 2 diabetes mellitus (97.1%), and (2.9%) were type 1 diabetes mellitus.
The result of this study show that the majority of diabetic patients in the study sample (92.2%) had fasted all days of Ramadan (30 days), while 4.4% fasted 29 days. This study showed that 93.6% of diabetic patients did not have any hypoglycemic attacks during Ramadan fasting. Only 3.9% of diabetic patients had one hypoglycemic attack, 1.5% had two attacks, 0.5% had three attacks, while 0.5% had six attacks. 83.3% emphasized that they had no health difficulty during Ramadan fasting, while 16.2 sometimes had health difficulties during Ramadan fasting. Most of the diabetic patients in this study, 91.6%, had been educated bytheir treating physicians about fasting in Ramadan, and 96.6% of diabetic patients had adjusted their oral hypoglycemic agents and insulin during Ramadan fasting.
Conclusion: The majority of type 2 Diabetic patients fasted during Ramadan without difficulties, and most had adjusted their oral hypoglycemic agents. It is important and essential for primary health care physicians to educate their Muslim diabetic patients before Ramadan fasting, to clarify any misconception about adjustment of their hypoglycemic agents and insulin during Ramadan, and to avoid preventable complications like hypoglycemia which is sometimes fatal. Further community based studies are recommended to study diabetic patients' medical issues during Ramadan.