open access

Ahead of print
Research paper
Published online: 2021-03-05
Get Citation

A study of combined oral anti-diabetic drugs during Ramadan

Majid Alabbood, Nassar Alibrahim, Haider Alidrisi, Ali Alhamza, Ammar Almomin, Ibrahim Hussein
DOI: 10.5603/DK.a2021.0028

open access

Ahead of print
ORIGINAL ARTICLES
Published online: 2021-03-05

Abstract

Background. The safety and efficacy of combination tablets of metformin plus sulfonylurea or plus dipeptidyl peptidase-4 inhibitors have not been studied previously. This study aimed to compare the efficacy and safety of Gliconorm versus Sitavia plus among patients with type 2 diabetes mellitus who fast Ramadan.
Methods. This was an open-label study conducted from 1 May 2018 till 1 July 2018. People with type 2 diabetes mellitus who were drug-naïve or on metformin only, with HbA1c < 10 % were included. The participants were divided into two groups. The first group was given Gliconorm (glibenclamide 5 mg + metformin 1000 mg), while the second group was given Sitavia plus (sitagliptin 50 mg + metformin 1000 mg) imme-diately after Iftar. Glycated hemoglobin (HbA1c) was measured before and after Ramadan. Several home recordings of blood glucose were collected. In addition, patients were asked to report any hypoglycemic or severe hyperglycemic episodes.
Results. A total of 34 participants (18 women) (19 in the first group and 15 in the second group) were involved the study. The mean age was 49.6 ± 9.3 years. HbA1c reduced from 8.7 % (72 mmol/mol) to 7.6 % (60 mmol/mol) and from 8.7% (72 mmol/mol) to 7.7 % (61 mmol/mol) in the first and second group, respectively (p < 0.0001). Only one patient in the first group experienced one episode of hypoglycemia and hyperglycemia.
Conclusion. Both medications seem to be safe and effective during Ramadan fasting. 

Abstract

Background. The safety and efficacy of combination tablets of metformin plus sulfonylurea or plus dipeptidyl peptidase-4 inhibitors have not been studied previously. This study aimed to compare the efficacy and safety of Gliconorm versus Sitavia plus among patients with type 2 diabetes mellitus who fast Ramadan.
Methods. This was an open-label study conducted from 1 May 2018 till 1 July 2018. People with type 2 diabetes mellitus who were drug-naïve or on metformin only, with HbA1c < 10 % were included. The participants were divided into two groups. The first group was given Gliconorm (glibenclamide 5 mg + metformin 1000 mg), while the second group was given Sitavia plus (sitagliptin 50 mg + metformin 1000 mg) imme-diately after Iftar. Glycated hemoglobin (HbA1c) was measured before and after Ramadan. Several home recordings of blood glucose were collected. In addition, patients were asked to report any hypoglycemic or severe hyperglycemic episodes.
Results. A total of 34 participants (18 women) (19 in the first group and 15 in the second group) were involved the study. The mean age was 49.6 ± 9.3 years. HbA1c reduced from 8.7 % (72 mmol/mol) to 7.6 % (60 mmol/mol) and from 8.7% (72 mmol/mol) to 7.7 % (61 mmol/mol) in the first and second group, respectively (p < 0.0001). Only one patient in the first group experienced one episode of hypoglycemia and hyperglycemia.
Conclusion. Both medications seem to be safe and effective during Ramadan fasting. 

Get Citation

Keywords

Ramadan; sulphonylurea; dipeptidyl peptidase-4 inhibitors; fasting; hypoglycaemia.

About this article
Title

A study of combined oral anti-diabetic drugs during Ramadan

Journal

Clinical Diabetology

Issue

Ahead of print

Article type

Research paper

Published online

2021-03-05

DOI

10.5603/DK.a2021.0028

Keywords

Ramadan
sulphonylurea
dipeptidyl peptidase-4 inhibitors
fasting
hypoglycaemia.

Authors

Majid Alabbood
Nassar Alibrahim
Haider Alidrisi
Ali Alhamza
Ammar Almomin
Ibrahim Hussein

References (28)
  1. Hassanein M, Al-Arouj M, Hamdy O, et al. Diabetes and Ramadan: practical guidelines. Diabetes Research and Clinical Practice. 2017; 126: 303–316.
  2. Salti I, Bénard E, Detournay B, et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care. 2004; 27(10): 2306–2311.
  3. Alabbood MH, Champion B. Managing people with diabetes during Ramadan. Endocrinology Today. 2017; 6(2): 38–40.
  4. Al Sifri S, Basiounny A, Echtay A, et al. The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: a randomised trial. Int J Clin Pract. 2011; 65(11): 1132–1140.
  5. Hassoun AAK, Al-Arouj M, Ibrahim M, et al. The effect of vildagliptin relative to sulphonylureas in Muslim patients with type 2 diabetes fasting during Ramadan: the VIRTUE study. Int J Clin Pract. 2013; 67(10): 957–963.
  6. Anwar A, Azmi KN, Hamidon BB, et al. An open label comparative study of glimepiride versus repaglinide in type 2 diabetes mellitus Muslim subjects during the month of Ramadan. Med J Malaysia. 2006; 61(1): 28–35.
  7. Aravind SR, Ismail SB, Balamurugan R, et al. Hypoglycemia in patients with type 2 diabetes from India and Malaysia treated with sitagliptin or a sulfonylurea during Ramadan: a randomized, pragmatic study. Curr Med Res Opin. 2012; 28(8): 1289–1296.
  8. Babineaux SM, Toaima D, Boye KS, et al. Multi-country retrospective observational study of the management and outcomes of patients with Type 2 diabetes during Ramadan in 2010 (CREED). Diabet Med. 2015; 32(6): 819–828.
  9. Bashir MI, Pathan MdF, Raza SA, et al. Role of oral hypoglycemic agents in the management of type 2 diabetes mellitus during Ramadan. Indian J Endocrinol Metab. 2012; 16(4): 503–507.
  10. Belkhadir J, el Ghomari H, Klöcker N, et al. Muslims with non-insulin dependent diabetes fasting during Ramadan: treatment with glibenclamide. BMJ. 1993; 307(6899): 292–295.
  11. Devendra D, Gohel B, Bravis V, et al. Vildagliptin therapy and hypoglycaemia in Muslim type 2 diabetes patients during Ramadan. Int J Clin Pract. 2009; 63(10): 1446–1450.
  12. Glimepiride in Ramadan (GLIRA) Study Group. The efficacy and safety of glimepiride in the management of type 2 diabetes in Muslim patients during Ramadan. Diabetes Care. 2005; 28(2): 421–422.
  13. Halimi S, Levy M, Huet D, et al. Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study. Diabetes Ther. 2013; 4(2): 385–398.
  14. Hanif W, Malik W, Hassanein M, et al. Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan. Curr Med Res Opin. 2013; 29(7): 807–811.
  15. Hassanein M, Abdallah K, Schweizer A. A double-blind, randomized trial, including frequent patient-physician contacts and Ramadan-focused advice, assessing vildagliptin and gliclazide in patients with type 2 diabetes fasting during Ramadan: the STEADFAST study. Vasc Health Risk Manag. 2014; 10: 319–326.
  16. Hassanein M, Hanif W, Malik W, et al. Comparison of the dipeptidyl peptidase-4 inhibitor vildagliptin and the sulphonylurea gliclazide in combination with metformin, in Muslim patients with type 2 diabetes mellitus fasting during Ramadan: results of the VECTOR study. Curr Med Res Opin. 2011; 27(7): 1367–1374.
  17. Loh HH, Yee A, Loh HS, et al. Comparative studies of dipeptidyl peptidase 4 inhibitor vs sulphonylurea among Muslim Type 2 diabetes patients who fast in the month of Ramadan: A systematic review and meta-analysis. Prim Care Diabetes. 2016; 10(3): 210–219.
  18. Mafauzy M. Repaglinide versus glibenclamide treatment of Type 2 diabetes during Ramadan fasting. Diabetes Res Clin Pract. 2002; 58(1): 45–53.
  19. Malha LP, Taan G, Zantout MS, et al. Glycemic effects of vildagliptin in patients with type 2 diabetes before, during and after the period of fasting in Ramadan. Ther Adv Endocrinol Metab. 2014; 5(1): 3–9.
  20. Peeters B, Mehuys E, Van Tongelen I, et al. Ramadan fasting and diabetes: an observational study among Turkish migrants in Belgium. Prim Care Diabetes. 2012; 6(4): 293–296.
  21. Schweizer A, Halimi S, Dejager S. Experience with DPP-4 inhibitors in the management of patients with type 2 diabetes fasting during Ramadan. Vasc Health Risk Manag. 2014; 10: 15–24.
  22. Shete A, Shaikh A, Nayeem KJ, et al. Vildagliptin vs sulfonylurea in Indian Muslim diabetes patients fasting during Ramadan. World J Diabetes. 2013; 4(6): 358–364.
  23. Ibrahim M, Abu Al Magd M, Annabi FA, et al. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Res Care. 2015; 3(1): e000108.
  24. Alabbood MH, Ho KW, Simons MR. The effect of Ramadan fasting on glycaemic control in insulin dependent diabetic patients: A literature review. Diabetes Metab Syndr. 2017; 11(1): 83–87.
  25. Cesur M, Corapcioglu D, Gursoy A, et al. A comparison of glycemic effects of glimepiride, repaglinide, and insulin glargine in type 2 diabetes mellitus during Ramadan fasting. Diabetes Res Clin Pract. 2007; 75(2): 141–147.
  26. Bruce DG, Davis WA, Davis TM. Glycemic control in older subjects with type 2 diabetes mellitus in the Fremantle Diabetes Study. J Am Geriatr Soc. 2000; 48(11): 1449–1453.
  27. McGill JB, Vlajnic A, Knutsen PG, et al. Effect of gender on treatment outcomes in type 2 diabetes mellitus. Diabetes Res Clin Pract. 2013; 102(3): 167–174.
  28. Misra R, Lager J. Ethnic and gender differences in psychosocial factors, glycemic control, and quality of life among adult type 2 diabetic patients. J Diabetes Complications. 2009; 23(1): 54–64.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl