P0685 - Muslim Pediatric Fasting Practices Among Diabetic Children: A Mixed Method Approach

Background/Purpose
Fasting during the holy month of Ramadan is one of the primary pillars of Islam. Muslims abstain from all water, food, and medications from dawn to dusk for the duration of the entire month. Exemptions are made for multiple subgroups, including children before the age of puberty and those with chronic medical conditions. Currently, the existing medical literature focuses on health outcomes among Muslim adults who fast, especially among diabetic patients. To date, there is no study that assesses fasting practices among diabetic children in the US.

This abstract is part of a longitudinal multi-phase study assessing Muslim pediatric fasting practices and and the current clinical practice of their physicians in Michigan. The purpose of this phase of the study is to assess the clinical outcomes of pediatric patients with diabetes who fast during Ramadan.

Methods
Following IRB approval, a mixed method study was conducted that included a retrospective chart review and digital survey. A retrospective chart review was conducted for pediatric patients with diabetes who were routinely followed at the Children’s Hospital of Michigan Endocrinology Clinic. In addition, parents of Muslim pediatric patients with diabetes were surveyed using a 5-part questionnaire at the Endocrinology Clinic during routine follow-up appointments.

Results
From September 2019 to February 2020, a total of 52 participants were surveyed. All participants identified as Muslim, 85% (44/52) identified as Arab/Arab American, 47% (22/47) identified as immigrants to the US, and 48% (21/44) had less than a high school diploma. A majority of participants, 92% (48/52) reported that their child had Type 1 Diabetes. Most parents, 76% (37/49), reported that their child was diagnosed with Diabetes before the age of 7 years old. About 27% (14/52) of patients fasted during Ramadan 2019, with a majority of them 79% (11/14) fasting 15 or more days during the month. Of those children who fasted during Ramadan, the average age of the child who fasted was 11 years old. In addition, parents checked their child’s blood sugar 3.5 times per day on average when fasting.

Overall, about 45% (18/40) of parents encouraged their child with diabetes to fast during Ramadan. Parents reported that diabetic control, age, and diabetes medication regiment were the primary factors that they considered when encouraging their child to fast.

Conclusion
Our study is unique in its multi-phase approach and mixed methodology. It is the first study of its kind that assesses fasting practices among Muslim pediatric patients with diabetes that fast during Ramadan in the US. Subsequent analyses will focus on assessing diabetic control of patients who fast and the impact of glucose sensors and insulin pumps on their clinical outcomes.