oa Screening For Diabetes In Ramadan - A Pilot Study

Diabetes is highly prevalent in Qatar and about 1/3 of patients are not aware of their diseases. Screening for undiagnosed diabetes is essential for effective management and prevention of diabetes and its complications. The effectiveness and cost analysis of several diabetes screening programs have been the subject of intensive investigation. Point of care (POC) measurement of capillary blood glucose (CBG) is very simple and can be applied widely, however, random CBG values are hard to interpret unless a high cut-off point is utilized, such as >200 mg/dL. A high cut off point would miss a large number of diabetics and pre-diabetics. POC CBG measurement of fasting and post-prandial values is difficult to organize in a community sitting. In Qatar, and all Muslim countries, most people observe fasting. If POC CBG is applied between 12:00 and sunset, then all values are at least 9 h after the morning meal and are considered fasting values. Similarly, POC CBG measured after evening prayer (Taraweeh) is equivalent to a late post-prandial value (~3 h after evening meal). Here we piloted a study to evaluate the usefulness of POC CBG to screen for diabetes in Ramadan after Juma'a prayer (~9 h of fast) and after Taraweeh prayer (3-4 h after evening meal - Iftar) in the large Mosq in Doha. We also administered a questionnaire to learn about known diabetes, co-morbidities and family history. A total of 2177 individuals were screened in 2 days, 75% were men and 25% were women representative of 40 different nationalities with most from Egypt (743, 38%), India (348, 23%) and Qatar (146, 7%). The distribution of CBG values were not statistically different between afternoon and evening values and were pooled for this analysis. 57% of all values were normal (<100 mg/dL). 27% had pre-diabetic CBG values (100-124 mg/dL). The remaining, 17% had diabetic values, 12% were previously known diabetic and 5% can be considered as newly diagnosed diabetes. Analysis of age, family history, ethnic background, comorbidities revealed the following facts: known DM were older, had more comorbidities (hypertension, kidney and heart diseases, and smoking). Presence of at least one diabetic parent existed in 37% of normal individual and 53% of known diabetics. Presence of two DM parents existed in only 8% of normal individual and 21% of known diabetics. There was a significant correlation between body weight and CBG values across the whole cohort when known diabetic values are excluded. In conclusion, this pilot study shows that Ramadan is an opportunity for screening for diabetes that can be applied on a wide community efficiently. *This study was financially supported by Action on Diabetes.