Multi-country retrospective observational study of the management and outcomes of patients with Type 2 diabetes during Ramadan in 2010 (CREED)

S M Babineaux, D Toaima, K S Boye, A Zagar, A Tahbaz, A Jabbar, M Hassanein, S M Babineaux, D Toaima, K S Boye, A Zagar, A Tahbaz, A Jabbar, M Hassanein

Abstract

Aim: To describe the characteristics and management of patients with diabetes who chose to fast during Ramadan in 2010.

Methods: This was a multi-country, retrospective, observational study, supplemented with physician and patient questionnaires, with data captured before, during and after Ramadan. A total of 508 physicians in 13 countries enrolled 3777 patients and a total of 3394 evaluable cases were analysed. We report on the subset of patients with Type 2 diabetes, which included 3250 patients (95.8%).

Results: Oral anti-hyperglycaemic therapy was the predominant pre-Ramadan therapy for most patients (76.6%). The treatment regimen was modified before Ramadan for 39.3% of all patients (34.9% for patients on oral drugs alone, 47.1% for patients on injectable drugs alone). Almost all physicians (96.2%) reported providing fasting-specific advice to patients and 62.6% report using guidelines or recommendations for the management of diabetes during Ramadan. In all, 64% of patients reported fasting everyday of Ramadan and 94.2% fasted for at least 15 days.

Conclusions: Physicians have increasingly adopted multiple approaches to the management of fasting during Ramadan, including the adoption of international and/or national guidelines, providing fasting-specific advice and adjusting treatment regimens, such that patients are able to fast for a greater number of days without acute complications. Additional research is needed to explore physician and patient beliefs and practices to inform the evidence-based management of diabetes while fasting, both during and outside of Ramadan, and to identify and address barriers to the universal uptake of techniques to facilitate that management.

© 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

References

    1. Salti I, Benard E, Detournay B, Bianchi‐Biscay M, Le Brigand C, Voinet C et al A population‐based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 2004; 27: 2306–2311.
    1. Miller T. Mapping the Global Muslim Population. Washington, DC: Pew Research Center's Forum on Religion & Public Life; 2009. January 2011. Available at: Last accessed 24 September 2013.
    1. International Diabetes Federation . IDF Diabetes Atlas 5th Edition 2012 Update. 2012. Available at: Last accessed 24 September 2013.
    1. Al‐Arouj M, Bouguerra R, Buse J, Hafez S, Hassanein M, Ibrahim MA et al Recommendations for management of diabetes during Ramadan. Diabetes Care 2005; 28: 2305–2311.
    1. Al‐Arouj M, Assaad‐Khalil S, Buse J, Fahdil I, Fahmy M, Hafez S et al Recommendations for management of diabetes during Ramadan: update 2010. Diabetes Care 2010; 33: 1895–1902.
    1. Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan Education and Awareness in Diabetes (READ) programme for Muslims with Type 2 diabetes who fast during Ramadan. Diabet Med 2010; 27: 327–331.
    1. Beshyah SA. Fasting During The month of Ramadan For People With Diabetes: Medicine and Fiqh United at Last. Ibnosina J Med Biomed Sci 2009; 1: 58–60.
    1. Cegedim Group . Data Overview ‐ OneKey Database. 2012. Available at: Last accessed 23 September 2013.
    1. Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nat Rev Endocrinol 2012; 8: 228–236.
    1. Al Sifri S, Basiounny A, Echtay A, Al Omari M, Harman‐Boehm I, Kaddaha G et al The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: a randomised trial. Int J Clin Pract 2011; 65:1132–1140.
    1. Aravind SR, Al Tayeb K, Ismail SB, Shehadeh N, Kaddaha G, Liu R et al Hypoglycaemia in sulphonylurea‐treated subjects with type 2 diabetes undergoing Ramadan fasting: a five‐country observational study. Curr Med Res Opin 2011; 27:1237–1242.
    1. Hassanein M, Hanif W, Malik W, Kamal A, Geransar P, Lister N et al Comparison of the dipeptidyl peptidase‐4 inhibitor vildagliptin and the sulphonylurea gliclazide in combination with metformin, in Muslim patients with type 2 diabetes mellitus fasting during Ramadan: results of the VECTOR study. Curr Med Res Opin 2011; 27: 1367–1374.
    1. Ahmedani MY, Haque MS, Basit A, Fawwad A, Alvi SF. Ramadan Prospective Diabetes Study: the role of drug dosage and timing alteration, active glucose monitoring and patient education. Diabet Med 2012; 29: 709–715.

Source: PubMed

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