Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan

Hanif, Wasim; Malik, Waqar; Hassanein, Mohamed; Kamal, A; Geransar, Parnia; Andrews, Chris; Azam, Muhammad; Barnett, Anthony

doi:10.1185/03007995.2013.803054

Cited by 17 publications

(14 citation statements)

References 11 publications

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“…There were no hypoglycemic events (defined as blood glucose level less than 70 mg/dL; 3.9 mmol/L) for patients in the vildagliptin group while 44.4% of the patients in the SU group suffered from hypoglycemic events. There was significantly greater HbA 1c reduction for those taking vildagliptin; however this higher effectiveness may be attributed to higher adherence rate by patients using vildagliptin than for those using gliclazide [19]. On the other hand the high missing rate among patients using gliclazide is a confirmation to the finding of this study in that vildagliptin despite regular usage resulted in fewer hypoglycemic events.…”

Section: Resultssupporting

confidence: 67%

Effectiveness and Safety of Newer Antidiabetic Medications for Ramadan Fasting Diabetic Patients

Mikhael

2016

Journal of Diabetes Research

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Hypoglycemia is the most common side effects for most glucose-lowering therapies. It constitutes a serious risk that faces diabetic patients who fast during Ramadan (the 9th month in the Islamic calendar). New glucose-lowering classes like dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide 1 receptor agonist (GLP-1 RA), and sodium-glucose cotransporter-2 (SGLT-2) inhibitors are efficacious in controlling blood glucose level with less tendency to induce hypoglycemia and thus may constitute a good choice for diabetic patients during Ramadan. This study reviews the safety and efficacy of newer glucose-lowering therapies during Ramadan. This study was accomplished through a careful literature search about studies that assess the benefit and side effects of these new glucose-lowering therapies during Ramadan during September 2015. Vildagliptin, sitagliptin, liraglutide, exenatide, and dapagliflozin were the only studied glucose-lowering therapies. All of the studied newer glucose-lowering therapies except dapagliflozin were associated with reduced risk to induce hypoglycemia. Gastrointestinal upset was common with the usage of liraglutide while increased thirst sensation was common with dapagliflozin. In conclusion DPP-4 inhibitors such as vildagliptin and sitagliptin may form a suitable glucose-lowering therapy option for Ramadan fasting patients.

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Section: Resultssupporting

confidence: 67%

Effectiveness and Safety of Newer Antidiabetic Medications for Ramadan Fasting Diabetic Patients

Mikhael

2016

Journal of Diabetes Research

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“…Bodyweight remained constant in both cohorts (78.8 kg pre- and post- Ramadan with vildagliptin [N=22] and 76.4 and 76.8 kg, respectively, with gliclazide [N=36]). A better treatment adherence during Ramadan was found for vildagliptin-treated versus gliclazide-treated patients 25. In the vildagliptin group, one patient (4.3%) missed a total of four doses, whereas in the gliclazide group, ten patients (27.8%) missed a total of 266 doses.…”

Section: Experience With Dpp-4 Inhibitors While Fasting During Ramadanmentioning

confidence: 85%

“…The second Ramadan study conducted with vildagliptin in the UK was a prospective, observational, nonrandomized, open-label, two-cohort study, called VECTOR (Vildagliptin Experience Compared To gliclazide Observed during Ramadan) 24,25. Of the 72 patients enrolled, 30 patients had been prescribed vildagliptin (50 mg bid) add-on to metformin (free or fixed combination) and 41 patients SU add-on to metformin before study start and continued this treatment during the study; one patient was not allocated to treatment 24.…”

Section: Experience With Dpp-4 Inhibitors While Fasting During Ramadanmentioning

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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“…High treatment adherence with vildagliptin during Ramadan has recently been shown to be better than that reported with SU in the VECTOR study [34]. Treatment adherence was also high overall in the VIRTUE study, but with a similar number of missed doses between cohorts [33].…”

Section: Discussionmentioning

confidence: 99%

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

et al. 2013

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AimTo assess in real life the rate of hypoglycemia during Ramadan in patients with type 2 diabetes (T2DM) in France, according to their ongoing dual therapy of metformin-vildagliptin or metformin-sulfonylurea/glinide (IS).MethodsProspective, non-interventional study with 2 visits (within 8 weeks before and 6 weeks after the end of Ramadan 2012). Study diaries were not used to collect events or record values of glucose monitoring. One hundred and ninety-eight patients on stable oral dual therapy for ≥2 months and with glycosylated hemoglobin (HbA1c) ≤8.0% were recruited by 62 centers: 83 in the IS cohort and 115 in the vildagliptin cohort.ResultsApproximately 90% of patients were from Maghreb. The two cohorts were well balanced: 60% men, mean age 59 years, BMI 28 kg/m2, metformin dose ~2,000 mg/day, and HbA1c 7.2%. Distinct therapeutic management was planned in view of Ramadan with drug-adaptation intended in 61.4% of IS and 18.3% of vildagliptin patients. Hypoglycemia was reported in 37% of IS and 34% of vildagliptin patients; episodes declared as confirmed in 30.8% and 23.5%, respectively, and episodes documented as adverse event (AE) in 17.9% (22 episodes) and 7.5% (13 episodes), respectively (P = 0.025). Severe episodes were reported in 3.9% of IS and 1.7% of vildagliptin patients. 10.4% of IS and 2.6% of vildagliptin patients reported severe episodes and/or unscheduled medical visits due to hypoglycemia (P = 0.029). Glycemic control remained stable in both cohorts. Compliance with fasting was high, as well as adherence to drug with ≥5 missed-dose for 15.4% of IS and 8.5% of vildagliptin patients.ConclusionAlthough the overall frequency of malaise suggestive of hypoglycemia was high, which would be expected with prolonged fasting in a well-controlled T2DM population during hot summer days, the incidence of more severe and better-documented episodes (AE, severe event, event leading to unscheduled medical visit) were much lower, with consistently less events with vildagliptin therapy.

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Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan

Abstract: During Ramadan fasting, treatment with vildagliptin resulted in better treatment adherence compared with SU in Muslim patients with type 2 diabetes mellitus. Study limitations are the sample size and the lack of diet and exercise data.

Cited by 17 publications

References 11 publications

Effectiveness and Safety of Newer Antidiabetic Medications for Ramadan Fasting Diabetic Patients

Effectiveness and Safety of Newer Antidiabetic Medications for Ramadan Fasting Diabetic Patients

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

Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study

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