title: Comparison of Ramadan-specific education level in patients with diabetes seen at a Primary and a Tertiary care center of Karachi-Pakistan.
abstract: OBJECTIVE
  To compare Ramadan-specific education level in fasting patients with diabetes at a Primary and a Tertiary care center.
  
  
  METHODS
  An observational study was conducted in the Outpatient departments of a Primary care center and a Tertiary care center in Karachi-Pakistan. Recruitment of patients started at the end of Ramadan 2011 and continued till three months after Ramadan 2011. All patients with diabetes who observed fast during the month of Ramadan 2011 were included in the study. In Primary care center, patients were attended by physicians only, while at Tertiary care center patients were seen by physicians, diabetes educator and dietician. For data collection, standardized questionnaire based interview was conducted on one to one basis by trained healthcare professionals. Same questionnaire was used at both the centers.
  
  
  RESULTS
  A total of 392 and 199 patients with diabetes recruited at Primary and Tertiary care centers, respectively. Ramadan-specific diabetes education received by 213 (55%) and 123 (61.80%) patients with diabetes at Primary and Tertiary care centers, respectively. Compared to Primary care center, patients at Tertiary care centers were more aware about components of Ramadan-specific diabetes education such as signs and symptoms of hypoglycemia and hyperglycemia, dose of medicines/insulin during Ramadan fasting, dose of medicines/insulin when not fasting, self-monitoring of blood glucose, dietary modifications, physical activity, adequate nutrition and adequate hydration during Ramadan (p<0.05).
  
  
  CONCLUSIONS
  It was observed that Ramadan-specific education level of patients at Tertiary care center was significantly better compared to patients at Primary care center.
authors.affiliation: The Aga Khan Hospital for Women (Garden), U-19, Hasan Apartment Extension, Hasan Square, Gulshan-e-Iqbal Block 13-D, Karachi, Pakistan.
authors.forename: Shabeen Naz
authors.initials: SN
authors.lastname: Masood
authors.affiliation: Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No 2, Karachi 74600, Pakistan.
authors.forename: Syed Faraz Danish
authors.initials: SF
authors.lastname: Alvi
authors.affiliation: Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No 2, Karachi 74600, Pakistan. Electronic address: research@bideonline.com.
authors.forename: Muhammad Yakoob
authors.initials: MY
authors.lastname: Ahmedani
authors.affiliation: The Aga Khan Hospital, Karachi, Pakistan.
authors.forename: Shazia
authors.initials: S
authors.lastname: Kiran
authors.affiliation: Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No 2, Karachi 74600, Pakistan.
authors.forename: Nimra Fatima
authors.initials: NF
authors.lastname: Zeeshan
authors.affiliation: Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No 2, Karachi 74600, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Basit
authors.affiliation: Honorary President International Diabetes Federation, Secretary General, Diabetic Association of Pakistan, and WHO Collaborating Centre, Karachi, Pakistan.
authors.forename: A Samad
authors.initials: AS
authors.lastname: Shera
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000523:psychology; D005215:Fasting / Q000523:psychology*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007514:Islam / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000592:standards; D012068:Religion and Medicine; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers / Q000592:standards
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Education; Fasting; Ramadan