ABSTRACT
Objective: To observe the role of Ramadan Specific Diabetes Education [RSDE] in the management of fasting patients with diabetes
Methods: This prospective study was carried out at out-patients department [OPD] of Baqai Institute of Diabetology and 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
Results: 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
Conclusion: 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
ABSTRACT
Background and aims: Fasting during Ramadan is obligatory for all Muslims across the world. Through literature review, it has been found out that there are various articles published for the awareness of patients and general population regarding safe fasting during Ramadan. But very few studies highlight the Ramadan specific knowledge of general practitioners engaged in providing care to people with diabetes
This study aims to describe the practice, knowledge and attitude of general practitioners regarding treatment and dietary modifications for people with diabetes during Ramadan across Pakistan
Methods: A cross-sectional descriptive study was undertaken among a sample of 274 general practitioners. Data was collected by means of a questionnaire that consisted of 25 questions that were structured according to three categories i-e. Ramadan specific knowledge, diet and physical activity and treatment modification related knowledge and practices of GPs
Results: Out of the total population of GPs surveyed, 70% responded correctly to the questions while 30% responded incorrectly. 1 /4[th] of GPs incorrectly responded to questions regarding basic concepts of diabetes and Ramadan. 1/3[rd] of GPs responded incorrectly regarding questions on diet. Almost 40% of the GPs responded incorrectly to the questions regarding drug dosage adjustment in people with diabetes during Ramadan. However, more than 80% responded in agreement regarding alteration in medication timings
Conclusion: Almost one third of the studied populations of general practitioners across Pakistan lack the knowledge of basic principles that are important to be employed in the management of diabetes during Ramadan. Hence there is need to promote educational programmes and CMEs to improve the knowledge of our GPs that should be reflected by their sound clinical practices in the field of diabetes
ABSTRACT
To find out the various factors associated with non-adherence to diet, physical activity and insulin among patients with type 1 diabetes. [T1DM]. This cross sectional study was conducted among T1DM subjects attending the Baqai Institute of Diabetology and Endocrinology [BIDE] and Diabetic Association of Pakistan [DAP], from July 2011 to June 2012.Clinical characteristics, anthropometric measurements, knowledge regarding type 1 diabetes along with adherence to dietary advice, physical activity and insulin were noted on a predesigned questionnaire and score was assigned to each question. Patients were categorized as adherent or non-adherent on the basis of scores obtained. Statistical Package for Social Sciences [SPSS] for windows version 17.0 was used to analyze the data. A total of 194 patients [Male 94, Female 100], with mean age of 17.9 +/- 6.4 years, mean duration of diabetes 5.37 +/- 4.96 years [38.1% > 5 yrs, 61.9% < 5 yrs] were included in the study. One hundred and fourteen [58.5%] patients were non adherent to dietary advice, 82[42.3%] non adherent to physical activity while 88.1% respondents were non adherent to their prescribed insulin regimen. Factors associated with non-compliance were family type, occupation and educational level of respondent's parents, duration of T1DM, family history of diabetes, frequency of visits to diabetic clinic, knowledge regarding diabetes, lack of family support and fear of hypoglycemia. Non adherence to prescribed treatment regimen in patient with TIDM is quite high. There is need to design strategies to help patients and their family members understand their treatment regimen in order to improve their adherence
ABSTRACT
To determine the frequency of microalbuminuria and its associations in type-2 diabetic subjects attending diabetes centers/clinics across Karachi, Pakistan. Two thousand one hundred subjects with type-2 diabetes were screened for microalbuminuria using Micral test strip II. A single screening test was performed in 25 diabetes centers/units in different districts of Karachi from January 2003 to December 2003. The overall prevalence of microalbuminuria was 34%. Mean age of subjects was 53.1 years + 11.9 years, mean BMI was 25.8 ' 4.1 and mean duration of diabetes was 8.8 ' 5.21 years. Fifty seven percent were males and 43% females. Sixty two percent of the subjects had a systolic blood pressure >130 mmHg. Forty five percent had a family history of diabetes and 5% had a family history of hypertension. Univariate analyses demonstrated significant associations between microalbuminuria and age, duration of diabetes, male gender, smoking status, microvascular and macrovascular complications, hypertension, high triglycerides, high serum LDL, low serum HDL, and high fasting and random blood sugars. When adjusted for the effects of other variables in the model, age, diastolic blood pressure, serum LDL and retinopathy were found to be significantly associated with microalbuminuria. The prevalence of microalbuminuria in type 2 diabetic subjects in this cross-sectional multicentre study across Karachi was 34% and this was significantly related to age, diastolic blood pressure, serum LDL and retinopathy