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Table 2 Select knowledge questions regarding fasting diabetes patient care

From: Diabetes patient management by pharmacists during Ramadan

Question Answer Correct response (n = 137,%)
Fasting diabetes patient risk stratification   
Type 1 diabetes patient High risk 83 (60.5)
Well-controlled patients using metformin Low risk 89 (64.9)
Well-controlled patients using sulfonylurea Moderate risk 44 (32.1)
Patients with history of recurrent hypoglycemia High risk 107 (78.1)
Pregnant patient High risk 84 (61.3)
Elderly patients in ill health High risk 90 (65.7)
Fasting diabetes patient advice
This patient must be referred to a physician for assessment before embarking on Ramadan fast All patients 12 (8.7)
This patient can safely fast with appropriate dose adjustment and frequent monitoring Moderate and low risk patients 86 (62.8)
This patient must be advised not to fast High risk patient 53 (38.7)
Diabetes patients should break their fast if blood glucose drops to equal or less than 60 mg/dL (3.3 mmol/L) True 107 (78.1)
Diabetes patients should break their fast if blood glucose reaches 70 mg/dL (4 mmol/L) in the first few hours after the start of the fast True 75 (54.7)
Fasting diabetes drug dosing adjustment for fasting
A 55 y.o. with type 2 diabetes takes metformin 500 mg po three times daily Take 1 g after Iftar meal & take 500 mg after Suhur meal 69 (50.4)
A 35 y.o. with type 2 diabetes takes sitagliptin po 100 mg once daily Take 100 mg after Iftar meal 82 (59.8)
A 35 y.o. with type 1 diabetes is well-controlled taking 20 units of insulin (Lantus®) at 9 a.m. and 15 units of insulin (Actrapid®) before each meal Adjust insulin Lantus to 16 Units with Suhur meal 10 (7.3)