Health Professional's Knowledge Practices in Morocco: The DTMAR Study

Abstract Ramadan holds profound spiritual and cultural significance for Muslims worldwide. In Morocco, where an estimated 2.88 million individuals live with diabetes, ensuring a safe and well-tolerated fast requires rigorous support and monitoring by health care professionals before and during this holy month. Despite the availability of international recommendations, no prior study has specifically investigated the Ramadan-related knowledge of Moroccan health care professionals involved in diabetes management. The primary objective of this study was to describe the practices, knowledge, and attitudes of health care professionals regarding therapeutic and dietary adaptations for patients with diabetes during Ramadan in Morocco. The secondary objective was to assess the sociodemographic profile of these professionals as well as the epidemiological and metabolic characteristics of their most recent patients. DTMAR study (DT: diabetes, MAR: Morocco), a descriptive cross-sectional study was conducted among a sample of 173 health care professionals across all regions of Morocco. Data collection was performed through an online questionnaire comprising 20 questions, covering sociodemographic characteristics, knowledge and practices related to diabetes care during Ramadan, and clinical data from their most recent patients. General practitioners represented the majority of respondents (57.8%). Most participants practiced in urban areas (93.6%), mainly in public hospitals (36.4%). Regarding knowledge, 57.2% reported relying primarily on international recommendations. Almost all participants (95%) provided therapeutic education, and more than 80% adjusted antidiabetic regimens. Nutritional counseling by more than half of respondents was consistent with the International Diabetes Federation/Diabetes and Ramadan International Alliance guidelines. However, a considerable proportion continued to rely on personal experience rather than standardized recommendations. Most health care professionals are aware of the specificities of managing diabetes during Ramadan. Nevertheless, a substantial number continue to rely primarily on personal experience. These findings highlight the importance of strengthening continuous education and structured training to align theoretical knowledge with effective clinical practice.