Health Education During Ramadan Fasting in Type 1 Diabetes
Condition: Diabetes Mellitus, Type 1; Fasting
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      Adult Muslims are obliged to start fasting during the month of Ramadan. Fasting entails
      refraining from all food, drink, tablets and injections(vitamins & fluids) between sunrise
      and sunset; a period which varies by geographical location and season.

      People with type 1 Diabetes are among those who are risky to fast this holy month in the
      Muslim faith and thus are exempted from fasting. Yet many patients fast in spite of medical
      advice and religious exemption and for those patients, healthcare professionals should
      provide the utmost care and continuous diabetes education.

      Different diabetes education modalities exist like DSME (Diabetes self-management education
      with proven efficacy. One modality is the Diabetes Conversation Map which delivers diabetes
      education interactively through a series of maps that address different issues in diabetes
      management and includes a specially designed Ramadan map.

      In this study, two modalities of Diabetes focused Ramadan education will be compared
      regarding aiding patients to fast Ramadan safely. One modality will be Diabetes conversation
      maps and the other the International Diabetes Federation Education modules.
    

Detailed description: 
      Adult Muslims are obliged to start fasting during the month of Ramadan. Fasting entails
      refraining from all food, drink, tablets and injections(vitamins & fluids) between sunrise
      and sunset; a period which varies by geographical location and season. Although exempt, many
      diabetics refuse to take this concession as they feel psychologically & spiritually inclined
      to fast along with other Muslims.

      Fasting at Ramadan carries a very high risk for people with T1DM. This risk is particularly
      exacerbated in poorly controlled patients and those with limited access to medical care,
      hypoglycemic unawareness, unstable glycemic control, or recurrent hospitalizations.

      Structured education interventions have been endorsed by the National Institute for Health
      and Clinical Excellence as important in empowering patients to improve their jour¬ney with
      diabetes. In a large observational study, patients who fasted during Ramadan without
      attending a structured education session had a fourfold increase in hypoglycae¬mic events,
      whereas those who attended an education pro¬gramme focusing on Ramadan had a significant
      decrease in hypoglycemic events.

      Conversation Map aims to help people with diabetes experience a healthier Ramadan. The
      interactive Map covers a number of topics including understanding the risks and complications
      of fasting and the importance of creating a diabetes management plan during this time.
    

Intervention name(s): IDF modules; Conversational Maps
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Patients in this arm will receive Pre-Ramadan education using IDF module for 4 weeks prior to Ramadan fasting; Patients in this arm will receive Pre-Ramadan Education using Ramadan Fasting Diabetes conversation map for 4 weeks prior to Ramadan fasting
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Diabetes MellitusType1;Fasting;Health Education;Hypoglycemia