Effectiveness and Safety of Newer Antidiabetic Medications for Ramadan Fasting Diabetic Patients
Table 1
Summary of the included studies.
Class studied
Medication
Type of study
Research conclusions
DPP-4 inhibitors
Vildagliptin as monotherapy
Small scale observational study
Vildagliptin was significantly more effective than SU to reduce and body weight; vildagliptin is associated with fewer hypoglycemic episodes than SU [12]
large scale multiregional observational study
Vildagliptin was significantly more effective to reduce and less inducing hypoglycemia than SU [13]
DPP-4 inhibitors
Vildagliptin as add-on therapy
Randomized small scale study
Vildagliptin has similar effectiveness on and body weight to gliclazide; vildagliptin was significantly less inducing of hypoglycemia than gliclazide [14]
Small scale, observational prospective study
Vildagliptin was not associated with hypoglycemic events while nearly half of the patients in the SU group suffered from hypoglycemic events. There was significantly greater reduction by vildagliptin than SU [15]
Small scale, randomized open-label study
Vildagliptin was less significantly associated with hypoglycemia but with similar effectiveness on to SU [17]
Large, prospective observational study
Vildagliptin was associated with fewer episodes of severe hypoglycemia but with similar glycemic control to SU/glinide [18]
Large, multicenter, prospective observational study
Vildagliptin using patients suffered from hypoglycemia less frequently than those using SU. The reduction in was greater but not significantly different with vildagliptin than in SU [19]
Multiregional, large scale, randomized double blind study
Vildagliptin had similar effectiveness to lower but with less hypoglycemic risk than gliclazide [20]
DPP-4 inhibitors
Sitagliptin as add-on therapy
Pilot prospective observational study
Sitagliptin usage was not associated with hypoglycemic attacks [22]
Large, multinational randomized study
Sitagliptin was associated with significantly less risk of hypoglycemia than glibenclamide and glimepiride but similar risk to gliclazide [23]
Large, multicenter, randomized study
Sitagliptin was associated with significantly less risk of hypoglycemia than glibenclamide and glimepiride but higher hypoglycemic risk than gliclazide [24]
GLP-1 RA
Exenatide as add-on therapy
Pilot observational study
No risk of hypoglycemia even if pre-Ramadan dose of exenatide is not adjusted during Ramadan [27]
Observational study
Exenatide was associated with less risk of hypoglycemia than gliclazide [28]
GLP-1 RA
Liraglutide as add-on therapy
Small scale randomized study
Liraglutide was associated with significant reduction in body weight and nonsignificant but greater reduction in than SU Liraglutide was less significantly inducing hypoglycemia than SU [29]
Large, open-label, multinational randomized trial
Liraglutide was less likely to produce confirmed hypoglycemic attacks compared with SU. Moreover, patients on liraglutide experienced significantly greater weight loss and had significantly greater improvements in than those on SU [30]
SGLT-2 inhibitors
Dapagliflozin as add-on therapy
Randomized open-label study
There was a nonsignificant difference in the incidence of dehydration between patients in the dapagliflozin and SU group [34]
