Pharmacological approaches to the management of type 2 diabetes in fasting adults during Ramadan

Al-Maatouq, Mohamed A.

doi:10.2147/dmso.s23261

Cited by 26 publications

(28 citation statements)

References 36 publications

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“…In general, an adjustment of antidiabetic medications before Ramadan including marked dose reductions, and/or an increase in food/sugar intake when the fast is broken can underlie hyperglycemia during Ramadan. In addition, a long fasting period in the absence of adequate insulin can lead to excessive hepatic glycogen breakdown and increased gluconeogenesis, contributing to the development of hyperglycemia 4,6,7…”

Section: Introductionmentioning

confidence: 99%

Experience with DPP-4 inhibitors in the management of patients with type 2 diabetes fasting during Ramadan

Schweizer¹,

Halimi²,

Dejager³

2013

VHRM

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A large proportion of Muslim patients with type 2 diabetes mellitus (T2DM) elect to fast during the holy month of Ramadan. For these patients hypo- and hyperglycemia constitute two major complications associated with the profound changes in food pattern during the Ramadan fast, and efficacious treatment options with a low risk of hypoglycemia are therefore needed to manage their T2DM as effectively and safely as possible. Dipeptidyl peptidase-4 (DPP-4) inhibitors modulate insulin and glucagon secretion in a glucose-dependent manner, and consequently a low propensity of hypoglycemia has consistently been reported across different patient populations with these agents. Promising data with DPP-4 inhibitors have now also started to emerge in patients with T2DM fasting during Ramadan. The objective of this review is to provide a comprehensive overview of the currently available evidence and potential role of DPP-4 inhibitors in the management of patients with T2DM fasting during Ramadan whose diabetes is treated with oral antidiabetic drugs, and to discuss the mechanistic basis for their beneficial effects in this setting.

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Section: Introductionmentioning

confidence: 99%

Experience with DPP-4 inhibitors in the management of patients with type 2 diabetes fasting during Ramadan

Schweizer¹,

Halimi²,

Dejager³

2013

VHRM

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“…Sixty-two percent of our patients had low education level. High illiteracy rate is barrier for providing the necessary Ramadan-focused diabetes education [9].…”

Section: Discussionmentioning

confidence: 99%

Attitude of Patients with Diabetes Mellitus toward Fasting Ramadan in Basrah, Iraq

Mansour¹

2018

EMIJ

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Background: Ramadan fasting among diabetic patients is common despite their risk. Aim:The aim of this study was to know the attitude of patients with diabetes mellitus toward fasting Ramadan in Basrah. Methods:The study was conducted at Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah for the period from March to May 2012. Two hundred ninety-five patients were selected to participate in this study. Data collection was obtained from individually held face-to-face interviews between all patients and the same investigator using a standardized questionnaire. Results:Of 295 patients included, the mean age was 47.36 ± 15.0 years (65.4% females). About 49.4 % of the patients were on insulin with or without oral antidiabetic drugs (OAD) and 46.4% on OAD alone. Those who fasted last Ramadan were 188(63.7%) patients. Patients consulted their doctors to fast prior to Ramadan were 133 (70.7%). Of them only 46 (34.5%)patients were having permission to fast and 87(65.5%) patients fasted against medical advice. Almost all those who fast was for a religious reason and not to other cause like stop medications or insulin. Conclusion:Two third of diabetic fasted the last Ramadan. Majority of them consulted their doctor before fast. But two third fasted against medical advice.

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“…However, a majority of Muslim patients with type 2 diabetes mellitus (T2DM) do not consider themselves ill, and are ardent about their Ramadan fasting, despite the complications such as hyperglycemia and hypoglycemia, diabetic ketoacidosis, dehydration, and thrombosis. 2,3 The Population-based Epidemiology of Diabetes and Ramadan (EPIDIAR)study showed that there was a 7.5-fold increase in the risk of severe hypoglycemic events (HEs)and a 5-fold increase in hospitalization due to hypoglycemia in fasting patients with T2DM. 4 Therefore, the risk of hypoglycemia is to be taken into account while choosing or maintaining an antidiabetic agent during Ramadan.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Vildagliptin Compared to Sulphonylurea in Patients with Type 2 Diabetes during Fasting in Ramadan

Pathan

Amin

Afsana

et al. 2016

J. Bangladesh Coll. Phys.

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Summary:The objective of this study is to evaluate the efficacy and safety of vildagliptin compared to sulphonylurea (SU) in Type 2 Diabetes during Fasting in Ramadan. This was a prospective, observational cohort study, which enrolledpatients from Bangladesh. Patients aged >18 years with T2DM and HbA1c <8.5% were treated with vildagliptin or SU as add-on to metformin or as monotherapy for 16 weeks.The primary outcome of interest was to compare the proportion of patients with >1 hypoglycemic event(s) (HE) during fasting between the vildagliptin and SU groups. Changes in HbA1c, body weight and treatment adherence were also measured. Of the 100 patients enrolled, 97completed the study and 3 patients discontinued prematurely. Patients experiencing >1 HE(s) were fewer in the vildagliptingroup compared with SU group (4.3% vs. 8.2%; p=0.678). The reduction in HbA1c was 0.1% with vildagliptin from a baseline of 7.1%,however, there was no changewith SU from a baseline of 7.2% (between-treatment difference: "0.1%; p=0.600). A gain of 0.35kg and 0.08 kg was seen with vildagliptinand SUs treatment, respectively. Overall, the incidence of adverse events was similar betweenthe vildagliptin and SU groups (23.4% vs. 20.4%) with no new safety signals.The treatment with vildagliptin was associated with fewer hypoglycemic events compared with SU and was well tolerated in Muslim T2DM patients fasting during Ramadan.

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Pharmacological approaches to the management of type 2 diabetes in fasting adults during Ramadan

Cited by 26 publications

References 36 publications

Experience with DPP-4 inhibitors in the management of patients with type 2 diabetes fasting during Ramadan

Experience with DPP-4 inhibitors in the management of patients with type 2 diabetes fasting during Ramadan

Attitude of Patients with Diabetes Mellitus toward Fasting Ramadan in Basrah, Iraq

Efficacy and Safety of Vildagliptin Compared to Sulphonylurea in Patients with Type 2 Diabetes during Fasting in Ramadan

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