The association between Ramadan, pre-Ramadan diabetes education (PRE) and metabolic parameters in people with type 2 diabetes: A longitudinal study using routine primary care data.

Abstract

To assess the impact of Ramadan and pre-Ramadan diabetes education (PRE) on metabolic parameters in people with type 2 diabetes (T2D). Additionally, we described the proportion of Ramadan-related adverse events. A retrospective longitudinal study utilising Dutch routine primary care data from 133 people with T2D who participated in a PRE session. Linear Generalized Estimating Equations models were used to assess the association of metabolic parameters with Ramadan and PRE. We analysed free-text notes and a questionnaire to identify Ramadan-related adverse events. Ramadan was associated with modest reductions in HbA1c (β -1.07 mmol/mol; p = 0.07), systolic blood pressure (β -1.89 mmHg; p = 0.04), weight (β -0.81 kg; p < 0.01), BMI (β -0.29 kg/m²; p < 0.01), and a slight increase in triglycerides (β 0.27 mmol/l; p = 0.04) compared to non-Ramadan periods. PRE demonstrated no significant impact on metabolic parameters. The number of medical notes regarding Ramadan was small, with the mentioning of some physical complaints and medication errors. In our study, Ramadan is associated with temporary and marginal metabolic improvements in people with T2D. A single PRE session had no substantial impact on metabolic control. Healthcare professionals should more often discuss Ramadan and medication adjustments with their patients.