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Knowledge, attitude, and practices of fasts in patients with type 2 diabetes among different religions in North India

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Abstract

Background and objectives

There is no data regarding knowledge, attitude, and practices (KAP) of fasts in subjects with type 2 diabetes (T2DM) among different religions in India. Study was done to assess KAP regarding fasts among subjects with T2DM from various religions.

Material and methods

A total of 300 consecutive participants with T2DM (age ≥ 25 years) from 3 diabetes clinics in North India after consent were subjected to predesigned study pro forma.

Result

A total of 300 subjects participated in the study with 76.3% being Hindus, 11% Muslims, 4.3% Sikhs, and 5.7% from other religions (Christians and Buddhists). Knowledge and attitude regarding fasts in context of diabetes were poor in majority of subjects. 59.7% participants agreed that diabetic patients can fast. 36.3% participants believed that people with poor glycemic control (HbA1c ≥ 10%) can also observe fast. 40.7% believed medicines/insulins are not allowed during fasts because of religious reasons. 46.7% participants were aware of hypoglycemic symptoms. Among Hindus 2 most common fasts were Navratri (observed by 53%) and Karva Chauth (observed by 47.6%). Overall, 66.7% of Muslims observed Ramadan. Only 1.3% of participants discussed with their doctors before observing fast. 51.7% of participants who observed fasts had symptoms suggestive of hypoglycemia during fasts. 60.4% of subjects missed their medications during fasting. 28.8% altered their drug regimen by themselves without doctors’ consultation. 78.5% of participants observed fasts because of social obligations. Hindus were more likely to consult doctors during fasts and experienced comparatively lesser hypoglycemia and hyperglycemia as compared with Muslims and other religions. Women had greater inhibition to disclose about diabetes during fasts, were more likely to consult doctor during fasts, and perceived greater changes in body weight, hypoglycemia, and hyperglycemia during fasts.

Conclusion

The study showed significant gaps in knowledge and attitude regarding fasts among subjects with T2DM, in spite of fasting being common among all religions. The different nature and duration of different fasts and associated religious practices may contribute to these differences.

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Correspondence to Deep Dutta.

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Arora, B., Gupta, L., Khandelwal, D. et al. Knowledge, attitude, and practices of fasts in patients with type 2 diabetes among different religions in North India. Int J Diabetes Dev Ctries (2019). https://doi.org/10.1007/s13410-019-00760-z

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Keywords

  • Diabetes
  • Fast
  • Religion
  • Hindu fast
  • Navratri
  • Karva Chauth
  • Ramadan
  • Diet
  • Knowledge