Interest of the therapeutic education in patients with type 2 diabetes observing the fast of Ramadan

Abstract

The fast of Ramadan is a dilemma for diabetic patients due to the complexity of the management of diabetes during this holy month and the multiple risks they face (hypoglycemia, etc.).
Objectives: Evaluate the impact of a structured protocol of therapeutic education in a sample of type 2 diabetes, who were authorized by their doctors to fast, on metabolic and anthropometric profiles.
Methods: This prospective study was conducted among 54 type 2 diabetic patients (28 men and 26 women) aged 36–65 years, recruited from National Nutrition Institute. Patients were divided into two groups: the first group (n=26) received an education session one to two weeks before the month of Ramadan; the second group (n= 28) did not have appropriate therapeutic education except therapeutic adjustments. All our diabetic patients benefited from anthropometric measurements, determination of body composition and metabolic assessment (HbA1c, cholesterol, triglycerides, etc.) before and after the month of Ramadan.
Results: The fast was completed without complications in 25 diabetic patients educated group and 22 control patients. We found that weight loss was greater among educated diabetic patients (-1.05 kg) than in controls (-0.58 kg), but without statistical significance. Body composition has not undergone significant changes in both diabetic groups. Therapeutic education has led to a decline of 0.27% in HbA1c in the educated group while glycemic control in diabetic patients uneducated remained stable. Furthermore, we observed a better lipid profile in diabetic patients educated than those who did not have education.
Conclusion: Our results justify the interest of patient education centered on the month of Ramadan in all type 2 diabetic patients observing the fast of the holy month. This education should be continued during Ramadan in order to fulfill this religious rite safely.