Diabetes, Metabolic Syndrome and Obesity (Oct 2018)
To fast or not to fast during the month of Ramadan? A comprehensive survey on religious beliefs and practices among Moroccan diabetic patients
Abstract
Eisa Al-Balhan,1,* Hicham Khabbache,2,* Abdelhadi Laaziz,2 Ali Watfa,3 Abdelkader Mhamdi,4 Giovanni Del Puente,5 Nicola Luigi Bragazzi5–8 1Department of Educational Psychology, College of Education, Kuwait University, Kuwait City, Kuwait; 2Faculty of Literature and Humanistic Studies, Sais, Sidi Mohamed Ben Abdellah University, Fez, Morocco; 3Faculty of Education, Kuwait University, Kuwait City, Kuwait; 4Department of Sociology, Sais, Sidi Mohamed Ben Abdellah University, Fez, Morocco; 5DINOGMI, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; 6UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, University of Genoa, Genoa, Italy; 7Gestalt Study Center (CSTG), Milano, Italy; 8Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, Genoa, Italy *These authors contributed equally to this work Background: Diabetes represents a major public health concern. According to the International Diabetes Federation, about 8%–9% of the population have diabetes, and rates are even higher among Muslim communities. Despite the risks, about half (43%) with type 1 diabetes and most (86%) of those with type 2 diabetes fast during Ramadan. However, there is a dearth of information concerning the determinants that drive diabetic people to fast. Therefore, the present study was designed to fill this gap in knowledge. Materials and methods: A sample of 201 subjects volunteered to take part in this study. Mean age was 45.39±15.74 years. Most participants were female, married and had received at least primary education. They fasted for 22.98±8.53 days. Results: For the overall questionnaire, the Cronbach’s alpha coefficient was found to be excellent (α=0.910). The coefficient was good, yielding a value of 0.879, for the items concerning Ramadan fasting beliefs and practices, whereas the subscale for religious beliefs and practices obtained a score of 0.847. At the univariate analysis, patients with complicated diabetes (n=66, 32.8% of the sample) fasted for 20.77±9.21 days vs subjects with diabetes (n=135, 67.2% of the interviewees), who fasted for 24.05±7.99 days. The difference was statistically significant (P=0.014). The multivariate analysis indicated that religious beliefs and practices influenced the number of fasting days in a statistically significant way, after adjusting for confounders (beta coefficient =−0.199, t=−2.917, P=0.004). Another variable that impacted on the number of fasting days was the presence of complications (beta coefficient=−0.194, t=−2.775, P=0.006). Conclusion: Our results warrant further studies in the field. Keywords: diabetes, Ramadan fasting, religious beliefs and practices, survey
