Alamri Omar Mohammed, Raposo António, Alshaikh Ayoub Ali, Alfheeaid Hani A, Alamri Ali Mohammed, Alasmri Mohammed Abdullah, Alwubayran Nada Mohammed, Shukri Ahmed Khaled, Alslamah Thamer, Albaridi Najla A, Ahmad Md Faruque, Otayf Abdullah Y, Saraiva Ariana, Alshahrani Najim Z
Department of Obstetrics and Gynecology, Abha Maternity and Children Hospital, Abha, Saudi Arabia.
CBIOS (Research Center for Biosciences and Health Technologies), ECTS (School of Health Sciences and Technologies), Lusófona University, Lisboa, Portugal.
Front Nutr. 2025 Aug 18;12:1643107. doi: 10.3389/fnut.2025.1643107. eCollection 2025.
Fasting during Ramadan poses distinct challenges for individuals with diabetes, especially pregnant women, due to increased metabolic demands and the heightened risk of hypoglycemia, hyperglycemia, and dehydration. Although medical guidelines often advise against fasting in this group, many women still choose to observe the fast. This study aims to explore diabetes self-efficacy and self-care behaviors during and after Ramadan among pregnant women.
This cross-sectional study was conducted during and after Ramadan 2025 at Abha Maternity Hospital in Aseer region in Saudi Arabia. Pregnant women with gestational or pre-existing diabetes were recruited. Data were collected using validated Arabic versions of the Diabetes Self-Efficacy Scale and the Summary of Diabetes Self-Care Activities questionnaire. Paired t-tests and correlation analyses were used to examine changes and relationships.
A total of 162 pregnant women with diabetes participated in this study. Self-efficacy scores remained stable during and after Ramadan (mean 4.8 vs. 4.9, = 0.2), while self-care scores declined significantly post-Ramadan (32.5 to 29.8, = 0.001). HbA1c distribution shifted slightly, with fewer participants in the <5.7% range after Ramadan and more in the 5.7-6.4% range. Most managed diabetes using oral drugs with diet and exercise (42%). Medical education was linked to higher self-care scores ( < 0.001), while trial fasting improved self-efficacy ( = 0.001). Perceived glycemic control improved post-Ramadan (difficulty decreased from 72.8 to 65.4%, p = 0.001). Hypoglycemia caused 26.5% of fast-breaking episodes, though "other reasons" were more common. Older age and higher pregnancy order correlated with lower self-care and self-efficacy, while education and perceived health showed positive correlation.
This study underscores the need for culturally sensitive, pregnancy-specific interventions to support safe fasting. Sustained education, individualized care, and preparation before Ramadan were linked to better outcomes, highlighting the importance of ongoing support beyond the fasting period for optimal diabetes management.
斋月期间禁食对糖尿病患者，尤其是孕妇构成了独特的挑战，这是由于代谢需求增加以及低血糖、高血糖和脱水风险升高。尽管医学指南通常建议该群体不要禁食，但许多女性仍选择遵守禁食规定。本研究旨在探讨斋月期间及之后孕妇的糖尿病自我效能感和自我护理行为。
这项横断面研究于2025年斋月期间及之后在沙特阿拉伯阿西尔地区的阿卜哈妇产医院进行。招募患有妊娠期糖尿病或孕前糖尿病的孕妇。使用经过验证的阿拉伯语版糖尿病自我效能量表和糖尿病自我护理活动问卷摘要收集数据。采用配对t检验和相关分析来检验变化和关系。
共有162名患有糖尿病的孕妇参与了本研究。斋月期间及之后自我效能感得分保持稳定（平均4.8对4.9，P = 0.2），而斋月后自我护理得分显著下降（从32.5降至29.8，P = 0.001）。糖化血红蛋白分布略有变化，斋月后糖化血红蛋白<5.7%范围的参与者减少，5.7 - 6.4%范围的参与者增多。大多数人通过口服药物结合饮食和运动来管理糖尿病（42%）。医学教育与更高的自我护理得分相关（P<0.001），而尝试禁食提高了自我效能感（P = 0.001）。斋月后自我感知的血糖控制有所改善（困难程度从72.8%降至65.4%，P = 0.001）。低血糖导致26.5%的破斋情况，不过“其他原因”更为常见。年龄较大和妊娠次数较多与较低的自我护理和自我效能感相关，而教育程度和自我感知的健康状况呈正相关。
本研究强调需要采取具有文化敏感性、针对孕妇的干预措施来支持安全禁食。持续的教育、个性化护理以及斋月前的准备与更好的结果相关，突出了禁食期之后持续支持对于优化糖尿病管理的重要性。
