Impact of Ramadan-focused diabetes education on hypoglycemia risk and metabolic control for patients with type 2 diabetes mellitus: A systematic review.

BACKGROUND: Ramadan 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. AIM: To evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters. METHODS: A 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. RESULTS: Seventeen 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. CONCLUSION: Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.

Family medicine capability in medical disaster response.

Every disaster often holds a potential for significant impacts on human health and life. Every new threat presents new challenges to health risk management. However, family medicine faces an uncertainty on the specific roles it can assume to support urgent efforts at disaster surge response. Its preparedness level remains unknown. This research project, designed to explore issues of family medicine competency in this changed disaster response environment, conducted a disaster preparedness and response workshop among 28 family medicine physicians, testing their learning rate using a pre-test-post-test data collection method. Pre-test results (38.11 percent, x = 10.67) indicate that family medicine practitioners as a group were not ready by competency to respond to a disaster event and may instead increase the life risks of disaster victims. Post-test results (x = 21.67, 77.39 percent) showed an average doubling of their learning levels, indicating the workshop effectiveness in improving their disaster preparedness and response competency.