Among diabetic patients, fasting is associated with increased risk of ketoacidosis, hypoglycaemia and dehydration. Previous randomised controlled trials and prospective studies have shown that intensive pre-Ramadan education on fasting is able to help patients fast successfully during Ramadan. At the same time, observational studies show that many diabetic patients are still able to fast successfully throughout Ramadan despite deficiencies in knowledge about fasting practices. We conducted a retrospective recall study in Klinik Kesihatan Jalan Perak, Penang to determine the factors associated with successful fasting. Patients were selected using convenience sampling. Successful fasting was defined as a patient fasted as intended, and not having to break-fast due to hypo/hyperglycaemia symptoms or hospitalization due to diabetic complications. Multiple logistic regression was used to determine independent factors associated with successful fasting. 113 patients were enrolled. 70.9% (n=80) of patients were able to fast successfully. Knowing the name of their diabetic medications were significantly associated with successful fasting (AOR=8.56, 95%CI: 2.04;35.8, p=0.003). Knowledge and fasting practices were not associated with successful fasting. We may identify patients who might not fast successfully by evaluating their understanding of their diabetic medications. They can then be targeted for further pre-Ramadan counselling. Nonetheless, an intensive pre-Ramadan counselling is still optimal if resources are available.
Factors Associated with Successful Fasting among Type 2 Diabetic Mellitus Patients during Ramadan: A Retrospective Recall Study
Abstrak
Pesakit kencing manis yang berpuasa mempunyai risiko keotasidosis, hipoglisemia dan kekurangan air. Kajian secara kawalan rawak dan kajian prospektif menunjukkan bahawa nasihat intensif sebelum Ramadan dapat membantu pesakit berjaya berpuasa. Tetapi, kajian observasi menunjukan bahawa banyak pesakit yang masih berjaya berpuasa hampir genap sebulan semasa bulan Ramadan tanpa pengetahuan berpuasa dan amalan hidup yang baik. Kajian ini dijalankan untuk meneroka faktor-faktor lain yang berkaitan dengan puasa yang berjaya. Kajian retrospektif ini dijalankan di Klinik Kesihatan Jalan Perak, Pulau Pinang. Sejumlah 113 orang pesakit telah menyertai kajian ini secara persampelan konvenien. Puasa yang berjaya ditakrifkan sebagai pesakit berpuasa tanpa berbuka atas gejala gula rendah atau tinggi, atau kemasukan hospital akibat daripada komplikasi kencing manis. Regresi logistik berganda digunakan untuk menguji kaktor-faktor yang berkait dengan puasa yang berjaya. Sebanyak 70.9% (n=80) pesakit berjaya berpuasa. Pengetahuan dan amalan puasa pesakit tiada kaitan dengan puasa yang berjaya. Tetapi, pesakit yang mengetahui nama ubat kencing manis (AOR=8.56, 95%CI: 2.04; 35.8, p=0.003) adalah berkaitan dengan puasa yang berjaya. Kita bercadang untuk menilai pemahaman pesakit tentang ubat-ubatan untuk mengenal pasti pesakityang mugkin tidak dapat Berjaya berpuasa supaya mereka mendapatkan kaunseling sebelum ramadan. Tetapi, nasihat berpuasa yang penuh adalah lebih bagus jika masa dan sumber tidak menjadi isu.
Kata kunci
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