THE IMPACT OF PRE-RAMADHAN WEBINAR ON FASTING IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

A PILOT STUDY

Abstract

INTRODUCTION
Tele-education is the new form of education delivery during the COVID-19 pandemic. Patients with Type 1 diabetes are required to attend pre-Ramadhan fasting education sessions in accordance with the latest ISPAD guideline. This study aims to assess the outcome of a structured preRamadhan webinar on diabetes self-care and knowledge during fasting in Type 1 diabetes adolescents.

METHODOLOGY
A pilot study on adolescents with T1DM attending University Malaya Medical Centre (UMMC) or Universiti Teknologi MARA (UiTM) clinics who wished to fast in Ramadhan, was conducted. Participants and parents were invited to attend the pre-Ramadhan online education session 1-4 weeks before Ramadhan. Teaching on Ramadhan Fasting (RF) regulations, the pre-requisites for RF, insulin injections and adjustment, self-monitoring blood glucose (SMBG) and the ideal Ramadhan diet were covered. The post-webinar survey was sent to all participants 3 weeks after Ramadhan.

RESULTS
Fifteen adolescents attended the teaching. Majority (80%) was 10-15 years old. Sixty percent were female. Eight parents (62%) responded to the post-webinar survey. Nine in ten patients/parents were unaware on the prior regulations of RF for T1DM. Despite this, 85% were encouraged to perform RF, and 77% have performed RF previously. During previous years, 82% had difficulties with BG stabilization, 55% had hypoglycemia and 9% had experienced diabetic ketoacidosis (DKA). For RF this year, several improvements were identified post-webinar: 69% had fewer complications (hypoglycaemia and DKA), 69% were more compliant with insulin injections, 85% were more confident with insulin adjustments and 38.5% made improvements with dietary modification during RF. SMBG (more than 3 times per day) improved from 81.8% to 84.6%.

CONCLUSION
This pilot study demonstrates that a pre-Ramadhan webinar during the Covid19 pandemic can improve knowledge and diabetes self-care amongst T1DM adolescents. Education via online platform is indeed a valuable alternative medium to reach out to fasting T1DM patients during Ramadhan.