Many Muslims observe Ramadan during the 9th month of the Islamic calendar. It is a period of prayer, charity-giving, and self-accountability. It also involves a religious practice that can test diabetes control: fasting. Pharmacists often have patients who practice fasting during Ramadan, and need to be familiar with appropriate interventions and counseling.
Investigators from The University of Sydney in Australia have examined community pharmacists' perspectives and professional services for patients with type 2 diabetes (T2D) who choose to fast during Ramadan. Their results, published in the journal Research in Social and Administrative Pharmacy, indicate that pharmacists need to heighten their awareness of Ramadan and related coping mechanisms for individuals with T2D.
People with diabetes and other chronic conditions should not fast during Ramadan, but estimates developed in 2010 found that globally, more than 50 million Muslims with diabetes do.
These investigators conducted interviews during June, July, and August 2015 with 21 pharmacists practicing in areas of ethnic diversity to identify themes and current practices in pharmacies. The results paint a picture of pharmacists who were willing to counsel about diabetes and fasting, but waited for Muslim patients to ask for assistance.
Almost all pharmacists who participated in this study encountered patients who were fasting, but didn't perceive a need to approach patients proactively.
Competence was a concern, with most pharmacists indicating they lacked resources to educate them on how to manage diabetes during fasting. (Pharmacists should note the journal Diabetes & Primary Care offers an article called Managing diabetes in people fasting during Ramadan for free at http://www.generalpracticemedicine.org/managing_diabetes_in_people_fasting_during_ramadan.pdf.)
Many pharmacists also reported practice barriers in addition to a need for training. They said that lack of time and the way their pharmacies and workflows were organized were impediments to counseling. They also cited patients' ages, cultural beliefs, linguistic proficiency, and privacy needs as barriers.
Many pharmacists indicated that patients—especially those who were older and more experienced—had good coping skills and needed no help. Patients often self-adjusted their dosing well, and helped others who were less experienced.
Pharmacists are urged to heighten their awareness of the effect of religious practices on diabetes, and offer assistance. Ramadan will start on Saturday, May 27, 2017 and will continue for 30 days until Sunday, June 25, 2017. In the Muslim calendar, holidays begin on the sunset of the previous day, so observing Muslims will celebrate Ramadan on the sunset of Friday, May 26. During Ramadan, those who fast take no food, drink, or intravenous substances during the daylight hours.
Almansour HA, Chaar B, Saini B. Pharmacists' perspectives about their role in care of patients with diabetes observing Ramadan. Res Social Adm Pharm. 2017;13(1):109-122. doi: 10.1016/j.sapharm.2016.02.006.