LAUSR

AIM The aim of this systematic review and meta-analysis was to assess the effect of Ramadan focused education on clinical and metabolic parameters in patients with type 2 diabetes who fast during Ramadan. METHODS Literature search was done in PubMed, Embase (Ovid), and the Cochrane Library. Quality assessment was done using the ROBINS-I and Cochrane tools for risk of bias and analyses were performed using RevMan version 5.1. RESULTS From 770 records, 430 full text studies were assessed. After exclusions, the final quantitative analysis included 16 studies. Pre-Ramadan education was associated with a significant reduction in HbA1c (SMD -0.46, 95% CI -0.65 to -0.27 P<0.05) and LDL (SMD -0.09, 95% CI -0.13 to -0.04 P<0.05), an increase in TG (SMD 0.07, 95% CI -0.23 to 0.93 P<0.05) and weight (SMD 0.44, 95% CI 0.06 to 0.81 P<0.05) and no change in hypoglycemic events, BMI, TC, HDL or blood pressure (P>0.05) during Ramadan. CONCLUSIONS This systematic review and meta-analysis shows that Ramadan-focused diabetes education leads to a decrease in HbA1c and LDL, but an increase in TG and weight during Ramadan. It also identifies a lack of head to head studies and limited observational studies with adequately assessed end-points.