To fast or not to fast during the month of Ramadan? A comprehensive survey on religious beliefs and practices among Moroccan diabetic patients.

Background: Diabetes represents a major public health concern. According to the International Diabetes Federation, about 8%-9% of the population have diabetes, and rates are even higher among Muslim communities. Despite the risks, about half (43%) with type 1 diabetes and most (86%) of those with type 2 diabetes fast during Ramadan. However, there is a dearth of information concerning the determinants that drive diabetic people to fast. Therefore, the present study was designed to fill this gap in knowledge.

Materials And Methods: A sample of 201 subjects volunteered to take part in this study. Mean age was 45.39±15.74 years. Most participants were female, married and had received at least primary education. They fasted for 22.98±8.53 days.

Results: For the overall questionnaire, the Cronbach's alpha coefficient was found to be excellent (α=0.910). The coefficient was good, yielding a value of 0.879, for the items concerning Ramadan fasting beliefs and practices, whereas the subscale for religious beliefs and practices obtained a score of 0.847. At the univariate analysis, patients with complicated diabetes (n=66, 32.8% of the sample) fasted for 20.77±9.21 days vs subjects with diabetes (n=135, 67.2% of the interviewees), who fasted for 24.05±7.99 days. The difference was statistically significant (=0.014). The multivariate analysis indicated that religious beliefs and practices influenced the number of fasting days in a statistically significant way, after adjusting for confounders (beta coefficient =-0.199, =-2.917, =0.004). Another variable that impacted on the number of fasting days was the presence of complications (beta coefficient=-0.194, =-2.775, =0.006).

Conclusion: Our results warrant further studies in the field.