Levels of health Awareness in diabetic patients during Ramadan 2026: Focus group discussion in Argoo, Northern Sudan

Abstract

Background: Diabetes mellitus is a major non-communicable disease in Sudan, and Ramadan fasting poses significant health risks for patients with diabetes. In 2025, the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance issued updated guidelines for the management of diabetes during Ramadan. This study explored the levels of health awareness among diabetic patients in Argoo, Sudan, regarding these updated guidelines during Ramadan 2026.Methods: A qualitative study was conducted using four focus group discussions (FGDs) with 29 participants purposively recruited from Argoo, Sudan. Thematic analysis, following the Braun and Clarke framework, was used to identify and analyze themes related to health awareness.Results: Six themes emerged: (1) Limited awareness of 2026 IDF-DAR guidelines; (2) Misconceptions about fasting safety; (3) Reliance on experiential knowledge over clinical advice; (4) Barriers to healthcare access; (5) Role of family and community influence; and (6) Desire for structured education. Participants demonstrated variable awareness, with many relying on informal practices and religious conviction rather than structured medical guidance.Conclusion: Diabetic patients in Argoo exhibit suboptimal awareness of updated Ramadan diabetes management guidelines. There is a critical need for community-based health education, culturally sensitive patient counseling, and improved healthcare access to reduce fasting-related complications during Ramadan.