Dabral Swarna, Mukherjee Shoma, Saha Nilanjan, Manjavkar Smita, Kohli Sunil
Department of Pharmacology, School of Pharmaceutical Education and Research, New Delhi, India.
Department of Pharmacology, Hamdard Institute of Medical Sciences and Research, New Delhi 110062, India.
Natl Med J India. 2020 Jan-Feb;33(1):5-9. doi: 10.4103/0970-258X.308233.
Many people with diabetes, who practise Islam, are passionate about fasting during Ramadan despite their medical condition and exemption from the religion. These patients are at risk of hypoglycaemia, hyperglycaemia, diabetic ketoacidosis, dehydration and thrombosis. We evaluated the acceptability of an individualized management plan for such people.
We conducted a survey to assess the knowledge and ability of patients to manage their diabetes while observing the fast during Ramadan. Then, the acceptance of an educational intervention was assessed among patients, which was provided 1 month before Ramadan. Patients were followed up at 2 weeks into and after Ramadan.
Of the survey population, only 14.7% of patients volunteered for pre-Ramadan assessment and 97.5% of patients recollected suffering from symptoms suggestive or hypoglycaemia or hyperglycaemia. Following the intervention, 17 of 50 patients did not fast; 26 patients followed dietary advice, while 7 patients did not. Symptoms suggestive of hypoglycaemia and hyperglycaemia were reported by 21 of 33 patients who fasted and 21 of 28 patients reported lower body weight. Insulin and hypoglycaemic drugs were changed from morning to evening dosing in 41% of patients while 18% of patients had their drugs stopped.
An educational intervention generated awareness among the patients and helped 43 of 50 patients in making rational decisions about control of diabetes during Ramadan.
许多患有糖尿病的穆斯林尽管患有疾病且宗教允许豁免，但仍热衷于在斋月期间禁食。这些患者有发生低血糖、高血糖、糖尿病酮症酸中毒、脱水和血栓形成的风险。我们评估了针对这类人群的个体化管理计划的可接受性。
我们进行了一项调查，以评估患者在斋月期间禁食时管理糖尿病的知识和能力。然后，在斋月前1个月对患者进行教育干预，并评估其接受程度。在斋月开始后2周及斋月结束后对患者进行随访。
在调查人群中，只有14.7%的患者自愿接受斋月前评估，97.5%的患者回忆起曾出现提示低血糖或高血糖的症状。干预后，50名患者中有17名未禁食；26名患者遵循了饮食建议，7名患者未遵循。33名禁食患者中有21名报告有提示低血糖和高血糖的症状，28名患者中有21名报告体重减轻。41%的患者将胰岛素和降糖药的给药时间从早晨改为晚上，18%的患者停止用药。
一项教育干预提高了患者的认识，并帮助50名患者中的43名在斋月期间就糖尿病控制做出了合理决策。
