The Association between Health-Related Quality of Life and Ramadan Fasting in Diabetic Patients: A Survey Using A Structured D-39 Assessment Tool. A Sudanese Cohort

Abstract

Introduction: Most cases of chronic diseases result in physical, psychological, financial, and social burdens on the patients and the economy. The overall health-related quality of life of patients can be positively influenced by several variables including glycemic control, economic status, comorbidities, presence of complications, and the quality of medical, psychological, and social support. Studies examining the effects of fasting on diabetes during Ramadan fasting underline the biochemical changes without considering the psychosocial and financial implications. This study aimed to illuminate some of the challenges faced by both fasting and non-fasting diabetic patients during Ramadan.Further, we evaluated the quality of life of diabetes patients, explored the socio-demographic and disease-related variables, and estimated the percentage of diabetic patients who fasted during Ramadan. Methods: This was a community-based cross-sectional study conducted from August 2015 to October 2015. Diabetes 39 instrument was administered to 112 patients with diabetes in Khartoum to evaluate their health-related quality of life during Ramadan. Results: Fifty-four percent of study participants were female and 64.3% of them were aged between 40-60 years old. Sixty-two participants were able to fast (55.4%) and fasted for more than 15 days. Half of the participants had, at least, one comorbidity, among which hypertension was the most common. Approximately 59% of fasting patients had mild impairment in their health-related quality of life, whereas 60% of non-fasting participants had moderate impairment. Limited stamina, and fear of hypoglycemia were the items with the highest mean scores in both groups. The fasting group had a lower average score (2.88) compared to the non-fasting group (3.66). This difference was statistically significant (p=0.033). Conclusion: Over 53% of study patients fasted for at least 1 day during Ramadan. Interestingly, Patients who fasted had a better health-related quality of life when compared to those who did not fast. Patients with hypertension and cardiac diseases were the subjects least able to fast during Ramadan.