Endocrine Abstracts

Introduction: Fasting in Ramadan is one of the five pillars of Islam. Without relevant medical advice and intervention, fasting can put patients with T2DM at an increased risk of serious complications. The aim of this study was to compare the effectiveness and safety of available oral anti diabetic drugs in treating type-2 diabetics during Ramadan fasting.

Methods: More than 400 T2DM patients were included in this 16-week prospective study, data were collected up to 6 weeks before and 16 weeks after Ramadan fasting. Patients who had received metformin alone or with sulfonylurea (SU), DPP4-I or TZDs or any combination of the afromentioned were enrolled into the study.

Results: This study concluded that mean total HbA1c improved during Ramadan (P<0.001). This study also found that patients treated with SUs experienced major hypoglycemic events Similarly, a fewer patients experienced weight gain when treated with TZDs. On the contrary we found that there was no evidence of hyperglycemia or hypoglycemia in patients using DPP4-I.

Conclusions: There are several potential benefits of fasting during Ramadan. Active glucose monitoring throughout the holy month of Ramadan enabled us to pick up more hypoglycaemic episodes. The study revealed that the preferred antidiabetic drugs during Ramadan are DPP4-I.

Keywords: DPP4 inhibitors, hypoglycemia, sulphonylureas, type 2 diabetes mellitus, TZDs, metformin