title: Effectiveness of contextual education for self-management in Thai Muslims with type 2 diabetes mellitus during Ramadan.
abstract: BACKGROUND
  Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines during Ramadan.
  
  
  OBJECTIVE
  To study outcomes of the specific health care services that providing health education in parallel with counseling by Islamic leader
  
  
  METHODS
  The Thai Muslims with type 2 diabetes mellitus were divided into two groups. There were 62patients in experimental group that was provided with specific health care service for Thai Muslims with diabetes in which health education prior to Ramadan and adjustment ofanti-diabetic medicine applied. The other was control group with 28patients that was provided only with original health care service. The results were monitored after Ramadan by interviews, weight and waist measurements, blood pressure measurement and blood tests.
  
  
  RESULTS
  Both mean systolic and diastolic blood pressure were well controlled in both groups and slightly decreased after Ramnadan. The mean diastolic blood pressure of the experimental group decreased after Ramadan (p-value = 0.041). From behavior point of view, it was found that the patients in the experimental group had consumed less sweetenedfood (p-value = 0.002). There was no incidence ofsevere hypoglycemia in either experimental or control group. The number and portion of patients with hypoglycemic symptoms in experimental group were lower than those in controlled group (p-value = 0.013).
  
  
  CONCLUSIONS
  Specific health care service by providing health education prior to Ramadan and adjustment ofanti-diabetic medicine application resulted in a positive effect as the patients tended to consume less sweetenedfood to keep blood sugar level in control. Fasting could affect the patients 'health in apositive way as it helps to control blood pressure, while in parallel, adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes mellitus type 2.
authors.forename: Prakaitip
authors.initials: P
authors.lastname: Susilparat
authors.forename: Junya
authors.initials: J
authors.lastname: Pattaraarchachai
authors.forename: Sriwatana
authors.initials: S
authors.lastname: Songchitsomboon
authors.forename: Savanit
authors.initials: S
authors.lastname: Ongroongruang
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001835:Body Weight; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005215:Fasting / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007514:Islam; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods*; D013785:Thailand
chemical_list: D007004:Hypoglycemic Agents