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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

Lookup NU author(s): Dr Huai Seng Loh

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Abstract

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.


Publication metadata

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


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