Questionaire

Questionaire


Center No.
Investigator Name (Initials)
Email

1) What is your specialty?
GP Internist Diabetologist Endocrinologist

2) How many diabetic patients you may see per month?
< 100 100-200 > 200  

3) What are the percentage of type 1 & type 2 in your clinic?
Type 1 Type 2    

4) Do you accept fasting for type 1 D.?
Yes No Occasional  

5) Do you accept fasting for type 2 D.?
Yes No Occasional  

6) What is the % of your D. patients who consult you before fasting Ramadan?
< 10% 10-25% 25-50% 50% All

7) What are your usual pre fasting assessments?
Cardiovascular Renal Hepatic Retinal

8) What are your usual diabetic assessments before permitting fasting?
FB glucose PP Glucose HbA1C All

9) Do you accept fasting for the elderly?
Yes No    

10) The elderly are those above:
60 y 65 y 70 y  

11) Do you accept fasting for diabetic patients with retinopathy?
Yes No    

12) Do you seek for retinopathy before fasting
Yes No    

13) Do you accept fasting for diabetic patients with CKD?
Yes No    

14) Do you assess GFR of diabetic patients before fasting?
Yes No    

15) Which level of with GFR refers to CKD?
< 90 ml/min <60 ml/min < 30  

16) Do you assess the autonomic function before fasting?
Yes No    

17) Do you accept fasting for diabetic patients with hypertension?
Yes No    

18) Do you accept fasting for D. patient with neurological deficit due to C.V. strokes?
Yes No    

19) Do you accept fasting for diabetic patients with stable angina?
Yes No    

20) Do you permit fasting for diabetic patient with history of hypoglycemia?
Yes No    

If No;
21) You advise your diabetic patient not to fast if hypogycemi episodes occurred within:
3 months before Ramadan 6 month before Ramadan Any history of hypoglycemia  

22) You advise your patient not to fast if number of hypoglycemic events were:
any number > one/month > one/week  

23) In patients with known precipitating factor for hypoglycemia (e.g.) missing a meal or drug over dose you still consider not to fast:
Yes No    

24) Do you accept fasting for diabetic patient with pregnancy:
Yes No    

25) Do you accept fasting for diabetic patient during lactation:
Yes No    

26) Do you accept fasting for patients with alternating shifts in their work:
Yes No    

27) Do you accept fasting for long distance drivers (> 3 hrs)?
Yes No    

28) Do you accept fasting for professional long distance driver?
Yes No    

29) Do you accept fasting for professional driver receiving medications which may cause hypoglycemia:
Yes No    

Follow up during fasting:
30) Do you allow fasting, if the patients have no tools for self monitoring?

Yes No Occasional  

31) How many times you advise the fasting patient to check his blood sugar?
Once Twice More symptoms-guided

32) Do you recommend breaking fasting in diabetic patient with severe hyperglycemia:
Yes No    

33) When you consider hyperglycemia as severe:
> 200 mg > 300 mg Symptomatic (e.g) polyurea & polydipsia

34) Do you recommend breaking fasting with hypos:
Yes No    

35) You consider hypoglycemia during fasting when B. glucose level is less than:
100 80 70  

36) Do you recommend physical exercise in Ramadan:
Yes No    

Treatment in Ramadan:
- OAD in type 2D patients

37) In type 2 D, how do you mange the oral therapy?
1- Continue as pre-Ramadan 2- Reduction of the dose 3- Change of the drugs regimen
2 & 3 Shift to other drugs    

38) The causes for changing regimens or drugs:
Better control of hyperglycemia Less hypos Both  

39) Which of the OAD continue without change?
Metformin DPP4I TZDs  
SUs Acarbase All  

40) Which of the following OAD are more subjected to changes in the dose or regimens?
Metformin DPP4I TZDs  
SUs Acarbase All  

41) For those subjected to dose reduction; the usual reduction is:
25% 50% More  

42) For those subjected to regimen changes:
Equal distribution between Iftar and Sohor    
Larger dose at Iftar and smaller at Sohor    
Reduction of drugs used (e.g.) from triple to dual therapy    

43) Which of the following drugs you consider more safe in Ramadan?
Metformin DPP4I TZDs  
Acarbase SUs Other "name"  

44) The modification you do on the drug therapy of type 2 D. are usually based upon:
International guidelines      
National guidelines    
Experts opinions in conferences or magazines    
Personal experience    

Insulin therapy in Ramadan
45) In patients treated with basal-oral regimen; what is your policy?
Continue as such    
Reduction of the insulin dose    
Changing human insulin to basal analogue    
Changing to analogue with reduction of the dose    

46) Patients controlled on pre-mixed oral regimen: what is your policy:
Continue as such    
Reduction of the insulin dose    
Shift to premixed analogue    
Shift to premixed analogue with dose reduction    

47) For type 2 patients totally dependent on insulin therapy which insulin type you prefer in Ramadan
Human insulin Insulin analogue    

48) For type 2 patients totally dependent on insulin which regimen you prefer:
Twice daily premixed Basal plus Basal-bolus Other

49) The usual dose of insulin used during fasting:
The same as before Ramadan      
Reduction of the pre-Ramadan dose by:    
20%    
30%    
More    

50) The usual distribution of insulin doses in Ramadan:
Equally distributed between Iftar & Sohour    
Large dose at Ifatar & smaller dose at Sohour    

51) The modification you do on the insulin therapy of type 2 D. are usually based upon:
International guidelines      
National guidelines      
Experts opinions in conferences or magazines    
Personal experience