Research project: Diabetes and Ramadan education program

Non WMO study



The prevalence of diabetes, especially type 2 diabetes mellitus (T2DM) is two to three times higher in people of a Moroccan or Turkish decent, when compared to the indigenous Dutch population. The majority of these patients are Muslim, which are required to fast during Ramadan. Although ill people are exempt from fasting, many Muslims with diabetes choose to fast during Ramadan. It is estimated that approximately 70.000 people with diabetes fast in the Netherlands.
During the fasting period the risk of developing acute T2DM-related complications, such as dehydration, hypo- and hyperglycaemia, is significantly increased. Although there are no quantitative data available on the scale of the problems during Ramadan in the Netherlands, healthcare professionals have the impression that they only have view of a small proportion of the problems concerning diabetes care during Ramadan. The aim of this implementation study is to develop an all-encompassing education program for Muslims with T2DM, on the basis of a successfully proven initiative in the United Kingdom.

The program will be implemented in Amsterdam. The elements of the program are: 1) the multidisciplinary and structured approach involving many local stakeholders (Muslim patients with T2DM, mosques, general practitioners and pharmacies), as well as 2) the specific “Diabetes and Ramadan” training for healthcare professionals 3 ) organization of education sessions for Muslims with T2DM both inside and as outside the mosques such as in general practices and community centers. 4) the dissemination of a homogeneous message regarding Diabetes and Ramadan by healthcare professionals and Imams in the region. The added value of this project is the development of a blueprint of a structured, national cooperation program, in which Muslims with T2DM are approached within their own cultural setting by use of a homogenous message, while using information materials that are cultural-specific and appropriate for people of low health literacy.

Structured cultural sensitive pre-Ramadan education helps people with diabetes who choose to participate in Ramadan fasting to experience a safer Ramadan period. Pre-Ramadan education reduces the risk of acute complications such as hypoglycemia. The program seems to provide patients with additional knowledge to self- manage their diabetes and to take responsibility for their diabetes care beyond the Ramadan. We think that the spreading of a homogenous message by healthcare professionals as well as Imams is a key factor that will support patients in making a responsible choice on whether to fast or not.

The Ramadan education session starts 4-6 weeks prior to Ramadan. To determine the effect and sustainability of education, we will analyze glycaemic control, weight and the incidence of complications due to fasting, 3 and 12 months after the program.

The program include education on general information about diabetes, the decision whether to fast or not, symptoms of hypo and hyperglycaemia (when to break the fast, glucose monitoring, medication adjustment, physical activity and meal planning. The education session will be provided in Dutch and in the native language of the patients.