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

• Main Authors: Loh, Huai Heng, Yee, Anne, Loh, Huai Seng, Norlela, Sukor, Nor Azmi Zmi, Kamaruddin
• Format: E-Article
• Language: English
• Published: Elsevier Ltd 2016
• Subjects: R Medicine (General)
• Online Access: http://ir.unimas.my/id/eprint/13598/7/Comparative%20studies%20of%20dipeptidyl%20peptidase%20%28abstract%29.pdf; http://ir.unimas.my/id/eprint/13598/; https://www.scopus.com/record/display.uri?eid=2-s2.0-84942044944&origin=resultslist&sort=plf-f&src=s&st1=Comparative+studies+of+dipeptidyl+peptidase+4+inhibitor+vs+sulphonylurea+among+Muslim+Type+2+diabetes+patients+who+fast+in+the+month+of+Ramadan%3a+A+s

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.