ObjectiveTo determine if individualized education before Ramadan results in a safer fast for people with type 2 diabetes.MethodsPatients with type 2 diabetes who received care from participating clinics in Egypt, Iran, Jordan and Saudi Arabia and intended to fast during Ramadan 2014 were prospectively studied. Twelve clinics participated. Individualized education addressed meal planning, physical activity, blood glucose monitoring and acute metabolic complications and when deemed necessary, provided an individualized diabetes treatment plan.Results774 people met study criteria, 515 received individualized education and 259 received usual care. Those who received individualized education were more likely to modify their diabetes treatment plan during Ramadan (97% vs 88%, p<0.0001), to perform self-monitoring of blood glucose at least twice daily during Ramadan (70% vs 51%, p<0.0001), and to have improved knowledge about hypoglycemic signs and symptoms (p=0.0007). Those who received individualized education also reduced their body mass index (−1.1±2.4 kg/m2 vs −0.2±1.7 kg/m2, p<0.0001) and glycated haemoglobin (−0.7±1.1% vs −0.1±1.3%, p<0.0001) during Ramadan compared those who received usual care. There were more mild (77% vs 67%, p=0.0031) and moderate (38% vs 19%, p<0.0001) hypoglycemic events reported by participants who received individualized education than those who received usual care, but fewer reported severe hypoglycemic events during Ramadan (23% vs 34%, p=0.0017).ConclusionsThis individualized education and diabetes treatment program helped patients with type 2 diabetes lose weight, improve glycemic control and achieve a safer fast during Ramadan.

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Background: Kangaroo care is one of the nursing practices with medical provision that can meet the important physical and emotional needs of the preterm such as warmth, stimulation, parental attachment, breast-feeding and safety. This study aimed to: assess the mothers' knowledge and practices about kangaroo mother care on weight gain of premature neonates in neonatal intensive care units. Research design: A quasi-experimental design was utilized in the current study. Setting: This study was conducted at neonatal intensive care unit in Beni Suef University Hospital. Subjects: A purposive sample of 50 mothers accompanying their premature infants. Tools of data collection: Three tools were used: tool (1) interviewing questionnaire: (pre, post and follow-up), tool (2) checklist of reported practices: (pre, post and follow-up), tool (3) knowledge of the mother about kangaroo care technique: (pre, post and follow-up). Results: More than three quarters of the studied mothers had unsatisfied knowledge about Kangaroo Mother Care in the pre educational program implementation while nearly all of them had satisfactory level of knowledge in the post educational program implementation....

Background: Juvenile diabetes remains one of the most complex chronic diseases in childhood. Adolescents and those of lower socio-economic status are at higher risk for poorer metabolic control and difficulties with psychosocial well-being. Juvenile diabetes can be associated with adverse effects on cognition during childhood and adolescence. Caring for children with Juvenile diabetes is typically the role of the mother. Mother must pay special attention to the promotion of good eating habits, stimulate physical activity, monitor blood sugar levels, make frequent visits to physicians and provide emotional support to the child. Aim of the study: This study aimed to assess mothers' knowledge and practices toward their children suffering from juvenile diabetes. Methods: This study was a descriptive, performed on 77 mothers whose children suffering from juvenile diabetes and attends to the out-patient pediatric diabetic clinic at the pediatric hospital affiliated to Ain Shams University Hospitals. Tools of data collection: A predesigned questionnaire to assess characteristics of the studied children and mothers, mothers' knowledge about juvenile diabetes and checklists of mothers' reported practices regarding care of their children suffering from juvenile diabetes. Results: Nearly two thirds of the studied mothers had unsatisfactory knowledge about juvenile diabetes, more than half of the studied mothers had incorrect reported practices regarding care for their children suffering from juvenile diabetes. In addition, there was a positive correlation between total knowledge of the studied mothers and their total reported practice. Conclusions: Mothers under study had unsatisfactory knowledge and incorrect reported practices regarding care of their children suffering from juvenile diabetes. In addition, there was a positive correlation between total knowledge of the studied mothers and their total reported practices. Recommendations: Establishing educational programs to improve knowledge and practices of mothers regarding care of their children suffering from juvenile diabetes. Further researches are needed to measure knowledge about juvenile diabetes in Egypt and its effect on the child care. Encourage the use of updated methods for education about juvenile diabetes as mobile messages, available means of information technology, one to one diabetes education and care for children and their mothers.

Background Fasting during the holy month of Ramadan is one of the five pillars of Islam. Fasting is not meant to create excessive hardship on the Muslim individual according to religious tenets. It is important that health professionals are aware of potential risks associated with fasting during the month of Ramadan (mainly hypoglycemia and hyperglycemia). Aims To explore the impact of applying the principles of our 2020 recommendations for the management of type 2 diabetes (T2D) during the month of Ramadan. Methods A multinational randomized controlled trial (RCT) was conducted in five Muslim majority countries. Six hundred and sixty participants were deemed eligible for the study; however, 23% declined to participate later for various reasons. In total, 506 participants were enroled and were equally randomized to the intervention or the control group. At the end of the study, data from 231 participants in the intervention group and 221 participants from the control group were collected after 12.6% and 8.7% were, respectively, lost to follow‐up. Participants were randomized to receive a Ramadan‐focussed education with treatment for diabetes adjusted as per our 2020 recommendation update compared with the local usual care (control group). Results are presented using mean, standard deviation, odds ratio (OR), and percentages. Results At the end of the study, the number of hypoglycemic episodes in the intervention group was less than in participants who received usual care. The intervention group had significantly lower severe hypoglycemia compared to the control group with an OR of 0.2 [0.1–0.8]. Compared to baseline, both groups had a significant reduction in glycated haemoglobin (HbA1c), but the improvements were significantly greater in the intervention group. Whilst body weight reduced and high‐density lipoprotein cholesterol increased with the intervention, these changes were not significantly different from usual care. Conclusions A pre‐Ramadan assessment of people with T2D coupled with pre‐Ramadan education and an adjustment of glucose‐lowering treatment as per our updated 2020 recommendations can prevent acute complications and allow a safer fast for people with T2D. We have shown that such an approach reduces the risk of developing severe hypoglycemia and improves the metabolic outcomes in people with T2D.