ArticlePloS one2022
"I am my own doctor": A qualitative study of the perspectives and decision-making process of Muslims with diabetes on Ramadan fasting.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Review of Muslim Patient Needs and Its Implications on Healthcare Delivery.Journal of primary care & community healthPooled it
- First-Time Usage of SGLT2 Inhibitors in Patients With Type 2 Diabetes Who Are Fasting Ramadan: Efficacy and Safety.Journal of diabetes research · 2025Trial
- Nutritional Needs, Dietary Knowledge, and Culinary Skills in Individuals with Diabetes Mellitus: A Scoping Review.Advances in nutrition (Bethesda, Md.) · 2026Article
- Improving knowledge on the management of diabetes mellitus during Ramadan.Journal of Taibah University Medical Sciences · 2025Article
- Changes in quality of vitamin K antagonist treatment and clinical outcomes during Ramadan: a Dutch population-based cohort study.Research and practice in thrombosis and haemostasis · 2025Article
- The influence of religiosity on food choice among British Muslims: A qualitative study.Nutrition and health · 2025Article
- Experiences of fasting during Ramadan in British Muslims: Psychological, social and health behaviours.PloS one · 2025Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany Muslims with diabetes choose to fast against medical advice during Ramadan, potentially increasing their risk of acute complications. Patients are often reluctant to disclose fasting to their health care providers, and their needs regarding Ramadan are not met in consultations. For healthcare professionals to provide patient-centred care, it is important to gain more insight into patients' decision-making process. This study therefore aims to explore how Muslims with diabetes decide whether to fast during Ramadan.
methodsA qualitative study was conducted consisting of 15 focus groups with Muslims with diabetes within a constructivist paradigm. Convenience sampling was used. All focus groups were transcribed verbatim and analyzed using Braun and Clarke's reflexive thematic analysis.
resultsFour themes were found to be important in the decision on whether to fast: (1) values and beliefs concerning Ramadan, (2) experiences and emotions concerning Ramadan, (3) the perception of illness, and (4) advice from health care professionals, imams and family. Many participants indicated fasting against medical advice and trusting their subjective assessments on whether they could fast. Moreover, three main stages in the decision-making process for eventually refraining from fasting were identified: (1) the stage where positive experiences with fasting dominate, (2) the stage where one encounters challenges but their determination to fast prevails and (3) the stage where one decides to refrain from fasting after experiencing too many physical difficulties with fasting.
conclusionsMuslims with diabetes experience autonomy in their decisions on Ramadan fasting. The decision to refrain from fasting often resulted from a difficult and dynamic decision-making process and was often made after participants reached their physical limits. These findings highlight the importance of not only shared decision-making to empower patients to make well-informed decisions on Ramadan fasting but also pre-Ramadan diabetes education to help people with diabetes have a safe Ramadan.
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