# Improving knowledge on the management of diabetes mellitus during Ramadan

## TL;DR

This study shows that an educational program significantly improves knowledge about managing diabetes during Ramadan fasting among Muslim patients.

## Contribution

The study demonstrates the effectiveness of a Ramadan-focused educational program in improving diabetes management knowledge.

## Key findings

- Overall good knowledge increased from 50.9% to 90.5% after the education program.
- Knowledge improved significantly in fasting risks, dietary principles, and medication-related risks.
- Glucose-monitoring frequency knowledge improved only modestly post-intervention.

## Abstract

Ramadan fasting is obligatory for adult Muslims but poses significant health risks for individuals with type 2 diabetes mellitus (T2DM), including hypoglycemia and hyperglycemia. This study evaluated baseline knowledge and the impact of a targeted educational program on DM management during Ramadan among adults with T2DM.

A single-arm pre-test/post-test design was conducted at Fatmawati General Hospital (February–April 2023) in a consecutive sample of 116 Muslim patients with T2DM who were planning to fast. Participants received a Ramadan-focused education session (online or offline) covering attendance, dietary planning, risk stratification, and self-monitoring. Knowledge was assessed with a 24-item questionnaire (6 attendance-related, 18 content-related questions). Data were analyzed using IBM SPSS Statistics version 22, with Kolmogorov–Smirnov tests for normality and paired t-tests or Wilcoxon signed-rank tests for pre-post comparisons (α = 0.05).

In the pre-intervention assessment, 50.9% of participants attained a “good” overall knowledge score, which increased significantly to 90.5% following the Ramadan-focused education program (Wilcoxon signed-rank test, p = 0.001). Domain-specific analyses revealed marked gains in understanding of fasting risks (from 63.8% to 92.2%), complex carbohydrate principles (37.9%–63.8%), physical activity recommendations (69.0%–78.5%), medication-related risk awareness (58.6%–81.0%) and risk stratification methods (83.9%–92.0%). By contrast, knowledge of the appropriate glucose-monitoring frequency improved modestly, reaching 67.2% post-intervention.

A structured, Ramadan-focused education program markedly enhances knowledge of safe fasting practices in patients with T2DM. To further optimize outcomes, future interventions should intensify focus on specific dietary strategies, sulfonylurea-related hypoglycaemia risks, and standardized glucose-monitoring protocols.