J Med Assoc Thai Vol. 97 Suppl. 8 2014 S1 Correspondence to: Pattaraarchachai J, Chulabhorn International College of Medicine, Thammasat University, Pathumthani 20120, Thailand. Phone: 0-2926-9796 E-mail: dr.junya@gmail.com J Med Assoc Thai 2014; 97 (Suppl. 8): Full text. e-Journal: http://www.jmatonline.com Effectiveness of Contextual Education for Self-Management in Thai Muslims with Type 2 Diabetes Mellitus During Ramadan Prakaitip Susilparat MD*, Junya Pattaraarchachai ScD**, Sriwatana Songchitsomboon ScD***, Savanit Ongroongruang ScD**** * PhD Candidate for Community and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand *** Graduate Program in Nutrition, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand **** Department of Community and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand Background: Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines during Ramadan. Objective: To study outcomes of the specific health care services that providing health education in parallel with counseling by Islamic leader. Material and Method: The Thai Muslims with type 2 diabetes mellitus were divided into two groups. There were 62 patients in experimental group that was provided with specific health care service for Thai Muslims with diabetes in which health education prior to Ramadan and adjustment of anti-diabetic medicine applied. The other was control group with 28 patients that was provided only with original health care service. The results were monitored after Ramadan by interviews, weight and waist measurements, blood pressure measurement and blood tests. Results: Both mean systolic and diastolic blood pressure were well controlled in both groups and slightly decreased after Ramadan. The mean diastolic blood pressure of the experimental group decreased after Ramadan (p-value = 0.041). From behavior point of view, it was found that the patients in the experimental group had consumed less sweetened food (p-value = 0.002). There was no incidence of severe hypoglycemia in either experimental or control group. The number and portion of patients with hypoglycemic symptoms in experimental group were lower than those in controlled group (p-value = 0.013). Conclusion: Specific health care service by providing health education prior to Ramadan and adjustment of anti-diabetic medicine application resulted in a positive effect as the patients tended to consume less sweetened food to keep blood sugar level in control. Fasting could affect the patients’ health in a positive way as it helps to control blood pressure, while in parallel, adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes mellitus type 2. Keywords: Thai Muslims, Ramadan, Diabetes mellitus type 2, Primary care units, Community medicine Diabetes mellitus is one of major concern for Global Muslims illness. Prevalence of diabetes in Muslims in the Middle East countries is high and still increasing (1) . During Ramadan, 40 to 50 million Muslims with diabetes mellitus around the globe fast for a period of approximately 30 days with the practice of prohibition in having food or drink during daytime. Allowed food courses are split into two; one before dawn called Suhur and the other right after dark called Iftar (2) . During the fasting, proper health care and practice should be followed otherwise the fasting may have downward effect to health. Most Muslims with diabetes mellitus decide and insist on fasting despite the risks or medical contraindications (3) . During the fasting period in the month of Ramadan, patients with diabetes mellitus type 2 had well controlled blood pressure; however, the biochemical parameters such as hemoglobin A1c, total cholesterol and triglycerides had no significant