Ahmedani Muhammad Yakoob, Ahsan Shahid, Haque Muhammad Saif Ul
Muhammad Yakoob Ahmedani, FCPS. Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No.2, Karachi, Pakistan.
Shahid Ahsan, MBBS, M.Phil (Biochemistry), M.Phil (Public Health). Associate Professor, Department of Biochemistry, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan.
Pak J Med Sci. 2017 May-Jun;33(3):586-593. doi: 10.12669/pjms.333.12345.
To observe the role of Ramadan Specific Diabetes Education (RSDE) in the management of fasting patients with diabetes.
This prospective study was carried out at out-patients department (OPD) of Baqai Institute of Diabetology & Endocrinology (BIDE), in 2012. Recruitment of patients started a month prior to Ramadan. Muslim patients with diabetes whether had their first or on follow up visit to the OPD and showed intention to hold fast in the month of Ramadan, were included. A printed broacher focused on six cardinal areas of fasting and diabetes identified in Ramadan specific guidelines was given to all participants. All patients had their first visit to the OPD (n=32) were also given RSDE on one-to-one basis (Group A). Whereas patients had follow up visit were advised to attend a group session on RSDE. Those attended (n= 25) and those did not opt (n=45) the group session were included in Group B and Group C respectively. All participants were instructed to visit the OPD after Ramadan. Group D was constituted after Ramadan. It included patients who had not visited the OPD during induction period thus did not receive RSDE (n=76) they however hold fast in the month of Ramadan. Data regarding compliance to structured education through different modes was collected during post Ramadan visit.
Comparisons among groups who received education(A with B with C) revealed non-significant difference in self-monitoring of blood glucose, alteration of drug dosage and timing, appreciation of hypoglycemia and action taken on development of hypoglycemic symptoms. However, significant differences were noted when group who received education was compared individually with group who did not receive education.
Patients who receive Pre-Ramadan diabetes education were found to be significantly better in following Ramadan specific diabetes management recommendations compared to patients who did not receive education. Further large scale studies are needed to validate our findings.
观察斋月特定糖尿病教育（RSDE）在糖尿病禁食患者管理中的作用。
这项前瞻性研究于2012年在巴凯糖尿病与内分泌研究所（BIDE）的门诊部进行。在斋月前一个月开始招募患者。纳入的是患有糖尿病的穆斯林患者，无论他们是首次到门诊部就诊还是复诊，并且表示有在斋月期间禁食的意愿。向所有参与者提供了一份印刷手册，该手册聚焦于斋月特定指南中确定的禁食和糖尿病的六个主要方面。所有首次到门诊部就诊的患者（n = 32）还接受了一对一的RSDE（A组）。而复诊患者则被建议参加RSDE小组会议。参加小组会议的患者（n = 25）和未选择参加小组会议的患者（n = 45）分别纳入B组和C组。所有参与者都被要求在斋月结束后到门诊部就诊。D组在斋月后组建。它包括在诱导期未到门诊部就诊因而未接受RSDE的患者（n = 76），不过他们在斋月期间禁食。在斋月后就诊期间收集了关于通过不同方式接受结构化教育的依从性数据。
接受教育的各组（A组、B组和C组）之间在血糖自我监测、药物剂量和时间调整、对低血糖的认识以及出现低血糖症状时采取的行动方面没有显著差异。然而，将接受教育的组与未接受教育的组分别进行比较时，发现存在显著差异。
与未接受教育的患者相比，接受斋月前糖尿病教育的患者在遵循斋月特定糖尿病管理建议方面明显更好。需要进一步开展大规模研究来验证我们的发现。
