• Ayla M Tourkmani, Osama Abdelhay, Turki J Alharbi, Abdulaziz M Bin Rsheed, Azmi HassaliMohamedMDiscipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia., Alian A Alrasheedy, Mohamed M Hassanein, Yasser K Alotaibi, Abdulmajeed M AlShowair, Wedad AlMadani, Abdulaziz M Alrabiah, Saad M AlBattal, Yasser A Albarkah, Azzam F AlOtaibi, Ibrahim A Alghofaili, and Mohammed S Al Eissa.
• Chronic Diseases Center, Family and Community Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
• Int. J. Clin. Pract. 2021 Mar 1; 75 (3): e13817.

BackgroundRamadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes.AimTo evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters.MethodsA systematic literature search was performed using Scopus, PubMed, Embase, and Google Scholar to identify relevant studies meeting the inclusion criteria from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and guidelines were followed when performing the search and identification of appropriate studies.ResultsSeventeen studies were included in this systemic review; five of them met the criteria to compile for a meta-analysis. The included studies were with various study designs, including randomised controlled trials, quasi-experimental and non-randomised studies. Overall, the results revealed a significant reduction of hypoglycemia risk (81% reduction) for fasting patients in intervention groups who received Ramadan-focused education compared with patients receiving conventional care (OR 0.19, 95% CI: 0.08-0.46). Moreover, HbA1c significantly improved amongst patients who received a Ramadan-focused diabetes education intervention, compared with those receiving conventional care.ConclusionRamadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.© 2020 John Wiley & Sons Ltd.

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