Effectiveness of Contextual Education for Self-Management in Thai Muslims with Type 2 Diabetes Mellitus During Ramadan
Prakaitip Susilparat MD*, Junya Pattaraarchachai ScD**, Sriwatana Songchitsomboon ScD***, Savanit Ongroongruang ScD****
Affiliation : * PhD Candidate for Community and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand *** Graduate Program in Nutrition, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand **** Department of Community and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the
patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines
during Ramadan.
Objective : To study outcomes of the specific health care services that providing health education in parallel with counseling
by Islamic leader.
Material and Method: The Thai Muslims with type 2 diabetes mellitus were divided into two groups. There were 62 patients
in experimental group that was provided with specific health care service for Thai Muslims with diabetes in which health
education prior to Ramadan and adjustment of anti-diabetic medicine applied. The other was control group with 28 patients
that was provided only with original health care service. The results were monitored after Ramadan by interviews, weight and
waist measurements, blood pressure measurement and blood tests.
Results : Both mean systolic and diastolic blood pressure were well controlled in both groups and slightly decreased after
Ramadan. The mean diastolic blood pressure of the experimental group decreased after Ramadan (p-value = 0.041). From
behavior point of view, it was found that the patients in the experimental group had consumed less sweetened food (p-value =
0.002). There was no incidence of severe hypoglycemia in either experimental or control group. The number and portion of
patients with hypoglycemic symptoms in experimental group were lower than those in controlled group (p-value = 0.013).
Conclusion : Specific health care service by providing health education prior to Ramadan and adjustment of anti-diabetic
medicine application resulted in a positive effect as the patients tended to consume less sweetened food to keep blood sugar
level in control. Fasting could affect the patients’ health in a positive way as it helps to control blood pressure, while in parallel,
adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be
achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes
mellitus type 2.
Keywords : Thai Muslims, Ramadan, Diabetes mellitus type 2, Primary care units, Community medicine
