Patients with Diabetes Observing Ramadan: The Experience of Muslims in the United States.

BACKGROUND AND PURPOSE: Little is known about the experience of Muslims with diabetes while fasting during Ramadan in the United States. Providing quality care for Muslim patients requires being aware of Islamic beliefs and practices, particularly in regard to healthcare ramifications. Therefore, the aims of this study were to (a) explore the beliefs which influence the experience and practices of diabetes management among Muslims in the United States during Ramadan, and (b) explore perspectives of Muslims with diabetes on their experience with healthcare providers providing support during their fasting experience.

METHODS: Using an exploratory design, semi-structured interviews were conducted for qualitative analyses. A purposive sample of 14 Muslim patients with diabetes was recruited from mosques located across North Carolina.

RESULTS: Analyses revealed six subthemes on their "feelings" that were inherent to their experiences of managing diabetes while fasting during Ramadan. These were organized into two main themes: 1) having diabetes and fasting during Ramadan and 2) fasting challenges. Having diabetes and fasting during Ramadan focused on the experience of fasting and comprised four "feelings": 1) feeling spiritually connected, 2) feeling socially connected, 3) feeling physically healthy, and 4) feeling religiously obligated. The second theme focused on fasting challenges and included 1) feeling sick and dehydrated, and 2) feeling vulnerable and poorly understood by healthcare providers.

CONCLUSION: This is the first known study to explore the experience of Muslims with diabetes while fasting during Ramadan in the United States. Our findings offer important insights into how Muslims manage their diabetes while fasting and the missed opportunities for relevant conversations when partnering with healthcare providers during Ramadan. The importance of cultural competency across healthcare systems in the United States cannot be overemphasized. Healthcare providers need to hold conversations embracing shared decision-making to resolve healthcare dilemmas resulting from cultural differences, expand cultural knowledge, and adapt services to meet culturally-unique needs of their patients.