The study subjects were randomly divided into an Intervention Group (those who receive psychoeducational and basic module approaches) and a Non-Intervention Group (those who only receive basic module education). Cortisol checking was only performed on the Intervention Group.
Consistent Implementation of the Five Pillars
In the first stage of the study, the psychoeducational modules for both facilitators and respondents, as well as one book concerning Type 1 DM treatment procedure for children and teens were successfully made. The second stage of the study shows that the pre-Ramadan psychoeducational approach succeeded in reducing the prevalence of hypoglycemia and hyperglycemia complications, and improve the blood sugar monitoring habit among children and teens with Type 1 DM in the Intervention Group.
“We hoped that the pre-Ramadan psychoeducational approach can prepare children and teen sufferers of Type 1 DM for a safe fasting ritual, and improve their confidence in same as well. We hoped that the psychoeducational module can also help health workers, especially doctors, in educating necessary Ramadan preparation to child and teen Type 1 DM sufferers in Indonesia,” dr. Bambang said.
The prevalence of Type 1 DM acute complications in this study is similar to what has been reported in studies performed abroad. Pre-Ramadan metabolic control with the cutoff point of HbA1c ≤ 8% as the safe limit for fasting shows that Type 1 DM sufferers with HbA1c ≥ 8% are at a higher risk of suffering from hyperglycemic acute complications, but this does not apply to hypoglycemia. The cortisol circadian cycle of Type 1 DM child and teen sufferers changed during fasting, but with a different pattern from the change that occurs in adult DM sufferers. It is also weakly related to the pattern of blood sugar variability during fasting.
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The study further proved that the administration of pre-Ramadan education, the optimizing of metabolic control prior to Ramadan, and strict daily monitoring of blood sugar levels during fasting improves the safety of fasting. It also proved that changes in the cortisol circadian cycle does not affect blood sugar variability pattern when one is fasting. Therefore, consistent compliance of the five pillars of Type 1 DM treatment process, plus psychoeducational approach of same prior to Ramadan, ensures the safety of fasting for children and teens as well. (est)