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 | Â | Â |
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 60Â mg/dL (3.3Â mmol/L) | True | 107 (78.1) |
Diabetes patients should break their fast if blood glucose reaches 70Â mg/dL (4Â 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 500Â mg po three times daily | Take 1Â g after Iftar meal & take 500Â mg after Suhur meal | 69 (50.4) |
A 35 y.o. with type 2 diabetes takes sitagliptin po 100Â mg once daily | Take 100Â 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) |