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Role of Ramadan specific diabetes education (RSDE); A prospective study.

ABSTRACT: To observe the role of Ramadan Specific Diabetes Education (RSDE) in the management of fasting patients with diabetes.This prospective study was carried out at out-patients department (OPD) of Baqai Institute of Diabetology & 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.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.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.

SUBMITTER: Ahmedani MY

PROVIDER: S-EPMC5510108 | biostudies-other | 2017 May-Jun

REPOSITORIES: biostudies-other

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Project description:INTRODUCTION:Diabetes mellitus (DM) has had a wide-ranging impact on healthcare politics. Secondary diseases and complications caused by diabetes are relevant cost and utilisation factors in the healthcare system. For decades, diabetes self-management education (DSME) has played a major role in the treatment of patients with type 2 DM (T2DM). The aim of this training is to empower patients to actively influence their diabetes process by gaining knowledge about health-related behaviours, such as healthy nutrition and exercise, and cardiovascular risks. The aim of the project is to analyse the practice of structured diabetes education and the effects of different learning types of participants. This project focuses on the needs of socioeconomically deprived patients and aims to improve DSME for this group. This patient group has a higher prevalence of T2DM, more complications and worse therapy-relevant parameters. METHODS AND ANALYSIS:The study will be conducted as a prospective longitudinal study. Patients will be recruited in outpatient physician offices over a period of 12 months. Patients will be included if they are 18 years and older, have T2DM and are scheduled to participate in DSME for the first time. A pseudonymised, written survey with standardised questionnaires will be administered. The data will be analysed using inferential statistical methods, such as correlation analysis, regression models and variance analytical designs. ETHICS AND DISSEMINATION:The study will be carried out following the principles of the Declaration of Helsinki and good scientific standards. Ethical approval of the Ethics Review Committee of the Medical Faculty at Martin-Luther-University, Halle-Wittenberg, was obtained. All participants in the study will receive comprehensive information and will be included after written informed consent is obtained. The results will be published in international peer-reviewed journals and presented at several congresses. TRIAL REGISTRATION NUMBER:DRKS00016630.

Project description:BackgroundLong-term sickness absences burden the economy in many industrialized countries. Both educational attainment and health behaviors are well-known predictors of sickness absence. It remains, however, unclear whether these associations are causal or due to confounding factors. The co-twin control method allows examining causal hypotheses by controlling for familial confounding (shared genes and environment). In this study, we applied this design to study the role of education and health behaviors in sickness absence, taking sex and cohort differences into account.MethodsParticipants were two cohorts of in total 8806 Norwegian twins born 1948 to 1960 (older cohort, mean age at questionnaire = 40.3, 55.8% women), and 1967 to 1979 (younger cohort, mean age at questionnaire = 25.6, 58.9% women). Both cohorts had reported their health behaviors (smoking, physical activity and body mass index (BMI)) through a questionnaire during the 1990s. Data on the twins' educational attainment and long-term sickness absences between 2000 and 2014 were retrieved from Norwegian national registries. Random (individual-level) and fixed (within-twin pair) effects regression models were used to measure the associations between educational attainment, health behaviours and sickness absence and to test the effects of possible familial confounding.ResultsLow education and poor health behaviors were associated with a higher proportion of sickness absence at the individual level. There were stronger effects of health behaviors on sickness absence in women, and in the older cohort, whereas the effect of educational attainment was similar across sex and cohorts. After adjustment for unobserved familial factors (genetic and environmental factors shared by twin pairs), the associations were strongly attenuated and non-significant, with the exception of health behaviors and sickness absence among men in the older cohort.ConclusionsThe associations between educational attainment, health behaviors, and sickness absence seem to be confounded by unobserved familial factors shared by co-twins. However, the association between health behaviors and sickness absence was consistent with a causal effect among men in the older cohort. Future studies should consider familial confounding, as well as sex and age/cohort differences, when assessing associations between education, health behaviors and sickness absence.

Project description:Education and income, as two primary socioeconomic indicators, are often used interchangeably in health research. However, there is a lack of clear distinction between these two indicators concerning their associations with health. This study aimed to investigate the separate and combined effects of education and income in relation to incident type 2 diabetes and cardiovascular diseases in the general population. Participants aged between 30 and 65 years from the prospective Dutch Lifelines cohort study were included. Two sub-cohorts were subsequently created, including 83,759 and 91,083 participants for a type 2 diabetes cohort and a cardiovascular diseases cohort, respectively. Education and income level were assessed by self-report questionnaires. The outcomes were incident type 2 diabetes and cardiovascular diseases (defined as the earliest non-fatal cardiovascular event). A total of 1228 new cases of type 2 diabetes (incidence 1.5%) and 3286 (incidence 3.6%) new cases of cardiovascular diseases were identified, after a median follow-up of 43 and 44 months, respectively. Low education and low income (<1000 euro/month) were both positively associated with a higher risk of incident type 2 diabetes (OR 1.24 [95%CI 1.04-1.48] and OR 1.71 [95%CI 1.30-2.26], respectively); and with a higher risk of incident cardiovascular diseases (OR 1.15 [95%CI 1.04-1.28] and OR 1.24 [95%CI 1.02-1.52], respectively); independent of age, sex, lifestyle factors, BMI, clinical biomarkers, comorbid conditions at baseline, and each other. Results from the combined associations of education and income showed that within each education group, a higher income was associated with better health; and similarly, a higher education was associated with better health within each income group, except for the low-income group. Education and income were both independently associated with incident type 2 diabetes and cardiovascular diseases. The combined associations of these two socioeconomic indicators revealed that within each education or income level, substantial health disparities existed across strata of the other socioeconomic indicator. Education and income are two equally important socioeconomic indicators in health, and should be considered simultaneously in health research and policymaking.

Project description:There are recent reports that Ramadan fasting (RF) results in weight gain instead of weight loss. In addition, the data on the efficacy of brief nutrition education on healthy eating practices in Ramadan for better health are scarce. Therefore, a study was conducted to investigate the effects of brief nutrition education before the start of RF on healthy eating practices during RF. For this purpose, a prospective observational study focused on "Dietary Education and Awareness for Ramadan (DEAR)" as an intervention was carried out. The participants (n = 74) were recruited and divided into two groups, i.e., intervention and control groups (n = 37 each). As an intervention, nutrition education lessons were given before and during RF month. The control group did not attend these nutrition education lessons. Data on anthropometrics, dietary intake, and other parameters were collected at three time points: before, in the end, and 4 weeks after RF. Weight was measured in kg; height, waist circumference (WC), and hip circumference (HC) were measured in cm; and body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was calculated by dividing the waist value by the hip value. Body composition analysis was performed by the body composition analyzer (BF-907). Blood pressure (BP) was measured using a validated automated blood pressure. A 3-5 ml of venous blood was collected, and plasma and serum were separated. Serum and plasma samples were processed for general blood chemistry (blood lipid profile, glucose, and CRP) within 2 h. CRP was determined by the immunoturbidimetry method using an auto-analyzer. An enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine/chemokines. Adherence to nutrition education (intervention) was assessed. The results show that nutrition education has positive effects on overall nutrition. Significant improvement in dietary adherence to dietary advice in the intervention group was noted. Significant BW loss (mean loss: 1.21 kg) in the intervention group was observed. The majority (63.3%) had lost BW ≥ 1.0 kg. Other changes observed as a result of the intervention included improvements in blood glucose, cholesterol, CRP levels, and systolic and diastolic BP. There was a notable shift in pro- and anti-inflammatory cytokine concentrations: IL-7, IL-4, and TGF-α decreased, while IL-2, TNF-α and resistin, IL-1 RA, IL-17 A, and sCD40 increased. In conclusion, RF resulted in a loss in mean BW and an improvement in related blood chemistry and cytokine profiles. Furthermore, nutrition education before RF resulted in better nutrition practices during RF and a desirable healthy BW, blood lipid, and cytokine profiles.

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Role of Ramadan specific diabetes education (RSDE); A prospective study.

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