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Summary:
The objective of this study is to evaluate the efficacy and safety
of vildagliptin compared to sulphonylurea (SU) in Type 2
Diabetes during Fasting in Ramadan. This was a prospective,
observational cohort study, which enrolledpatients from
Bangladesh. Patients aged >18 years with T2DM and HbA1c
<8.5% were treated with vildagliptin or SU as add-on to
metformin or as monotherapy for 16 weeks.The primary
outcome of interest was to compare the proportion of patients
with >1 hypoglycemic event(s) (HE) during fasting between
the vildagliptin and SU groups. Changes in HbA1c, body
weight and treatment adherence were also measured. Of the
100 patients enrolled, 97completed the study and 3 patients
discontinued prematurely. Patients experiencing >1 HE(s)
were fewer in the vildagliptingroup compared with SU group
(4.3% vs. 8.2%; p=0.678). The reduction in HbA1c was 0.1%
with vildagliptin from a baseline of 7.1%,however, there was
no changewith SU from a baseline of 7.2% (between-treatment
difference: “0.1%; p=0.600). A gain of 0.35kg and 0.08 kg
was seen with vildagliptinand SUs treatment, respectively.
Overall, the incidence of adverse events was similar betweenthe
vildagliptin and SU groups (23.4% vs. 20.4%) with no new
safety signals.
The treatment with vildagliptin was associated with fewer
hypoglycemic events compared with SU and was well
tolerated in Muslim T2DM patients fasting during Ramadan.
Keywords: DPP-4 inhibitor, Hypoglycemia, Ramadan, Type
2 Diabetes Mellitus, Vildagliptin, Sulphonylurea.
(J Banagladesh Coll Phys Surg 2015; 33: 120-125)

 

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