Practices of Arab American Patients With Type 2 Diabetes Mellitus During Ramadan

Aims: To examine practices and complications among Arab Americans observing fasting during Ramadan. Methods: Adults with type 2 diabetes mellitus, of native Arab ancestry, and observing fasting were invited to complete an interview. Changes made to behavioral characteristics or diabetes management during Ramadan and consequences of fasting were assessed. Results: Twenty-seven patients (60.1 ± 9.8 years, 51.9% male) participated. Majority reported exercising less frequently during Ramadan. Modifications in home blood glucose monitoring (HBGM) were observed in 48% of patients, of these 25% and 17% decreased frequency or had not tested at all, respectively. Consultation with providers prior to Ramadan was reported by 67%. Education regarding medications, risks of fasting, indications to break fasting, meal plans, and exercise were not provided in the majority. Therapeutic changes were made in 50% and 46% of insulin and oral medication users, respectively. Excessive thirst was the most commonly reported symptom. The overall frequency of hypoglycemia and hyperglycemia was low. One patient stopped fasting during Ramadan due to uncontrolled hyperglycemia. Hospitalization or emergency room visits were not reported. Conclusions: Lack of patient education prior to Ramadan may contribute to the suboptimal practices reported. Pharmacists may be able to ensure safe fasting practices among Arab Americans by providing patient-specific education.