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Lookup NU author(s): Dr Huai Seng Loh
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Aim: To systematically review the literature to compare the use of DPP4 inhibitors vs sulphonylurea in type 2 diabetic Muslim patients who fast in Ramadan, with regards to its safety, tolerability, glycemic control, and body weight changes.Methods: All English-language medical literature published from inception till October 2014 which met the inclusion criteria were reviewed and analyzed.Results: A total of nine papers were included, reviewed and analyzed. The total sample size was 4276 patients. All studies used either of the two DPP4 inhibitors - Vildagliptin or Sitagliptin, vs sulphonylurea or meglitinides. Patients receiving DPP4 inhibitors were less likely to develop symptomatic hypoglycemia (risk ratio 0.46; 95% CI, 0.30-0.70), confirmed hypoglycemia (risk ratio 0.36; 95% CI, 0.21-0.64) and severe hypoglycemia (risk ratio 0.22; 95% CI, 0.10-0.53) compared with patients on sulphonylureas. There was no statistically significant difference in HbA1C changes comparing Vildagliptin and sulphonylurea.Conclusion: DPP4 inhibitor is a safer alternative to sulphonylurea in Muslim patients with type 2 diabetes mellitus who fast during the month of Ramadan as it is associated with lower risk of symptomatic, confirmed and severe hypoglycemia, with efficacy comparable to sulphonylurea. (C) 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Author(s): Loh HH, Yee A, Loh HS, Sukor N, Kamaruddin NA
Publication type: Review
Publication status: Published
Journal: Primary Care Diabetes
Year: 2016
Volume: 10
Issue: 3
Pages: 210-219
Print publication date: 01/06/2016
Online publication date: 05/10/2015
Acceptance date: 03/09/2015
ISSN (print): 1751-9918
ISSN (electronic): 1878-0210
Publisher: ELSEVIER SCI LTD
URL: http://dx.doi.org/10.1016/j.pcd.2015.09.001
DOI: 10.1016/j.pcd.2015.09.001
