Physician Practice and Knowledge on Diabetes Management During Ramadan in Bosnia and Herzegovina

Introduction: Ramadan is the holy month of Muslims including fasting sometimes more than 20 hours. Even diabetes patients can be exempted from fasting it has been shown that almost 80% of diabetes type 2 patients intend and do fasting. To avoid acute complications during fasting, different recommendations on diabetes management are available. Considering the fact that there are more than 226 thousand diabetics in Bosnia and Herzegovina, it is important to provide structured support and healthcare service to those who are practicing fast during Ramadan. Aim: To evaluate knowledge, practice and attitudes of physicians treating diabetes (diabetologists and endocrinologists) in Bosnia and Herzegovina regarding management of diabetes in fasting patients during Ramadan. Methods: A 32 questions survey has been developed, validated and disseminated to the 27 specialists treating diabetes in Bosnia and Herzegovina through online form examining demographic characteristics, current practices and attitudes and knowledge on diabetes management during Ramadan. Results: All surveyed physicians deal with patients who are fasting during Ramadan. The majority of surveyed physicians 23 (85,2%) proactively initiate a discussion about planned fasting. More than 63,0% are following their experience and only 18,5% ADA/EASD guidelines on diabetes management during Ramadan. There are no significant differences between gender of the physicians, place of work and specialization when it comes to specific knowledge related to treatment guidelines, but some differences are observed. Conclusion: Although overall physicians` knowledge of diabetes management during Ramadan is satisfying there is opportunity in additional specialized education and measures introduction into the practice in order to improve treatment outcomes and standards of care.