Introduction: Although sick and pre-pubertal children are exempted from fasting, many patients with T1D choose to fast.
Objectives: To explore feelings & perceptions towards Fasting Ramadan of children &adolescents with uncontrolled type 1 diabetes (T1D) who insisted on fasting Ramadan against medical advice.
Methods: Before Ramadan, children and adolescents under 18 years with uncontrolled T1D received advice by their healthcare providers to not fast Ramadan to avoid the severity of acute complications. Shortly after the end of the month of Ramadan, the patients who fast against medical advice were invited to attend a focus group to discuss emotions towards fasting Ramadan. Data from the focus group was analyzed using thematic analysis.
Results: Forty-four patients with T1D duration 5.25 ± 4.32 y (age 12.7 ± 3.78 y); HbA1c 7.96% ± 1.34% (before Ramadan) participated in prior Ramadan education. 34% fasted against medical advice; 70.2% intend to fast again in the following years. The 4 main themes emerged from the focus group: 1- Proud to meet a religious obligation of Islam, 2-feeling happy sharing their fasting experience with the community and avoiding social stigma, 3-feeling "normal" as all their peers, 4- readiness to follow strict instructions to control diabetes to be able to fast again.
Conclusion: Although of the current Fasting Ramadan guidelines clearly highlight the risk of fasting Ramadan for T1D, especially in uncontrolled patients, still, many T1D individuals insist on fasting due to social stigma and misconceptions of religious rules, regardless of the risk they may face. Therefore, we need to develop a new protocol and guidelines to closely follow up with those individuals during fasting days. Adding to that the importance of Muslim Clerics' role in clarifying the opinion of religion in fasting Ramadan for people with chronic diseases to help them in improving acceptance and adherence to medical advice regarding fasting.
Z. Rahme: None. N. Mesbah: None. N. Taha: None. D. Alroudhan: None.
