Open AccessRole of oral hypoglycemic agents in the management of type 2 diabetes mellitus during Ramadan
Author(s) -
Muhammad Salman Bashir,
Faruque Pathan,
Syed Abbas Raza,
Jamal Ahmad,
A K Azad Khan,
Osama Ishtiaq,
Rakesh Sahay,
Aisha Sheikh,
Abdul Hamid Zargar
Publication year - 2012
Publication title -
indian journal of endocrinology and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 28
eISSN - 2230-9500
pISSN - 2230-8210
DOI - 10.4103/2230-8210.97994
Subject(s) - medicine , glimepiride , hypoglycemia , glibenclamide , diabetes mellitus , type 2 diabetes mellitus , tolerability , chlorpropamide , sulfonylurea , gliclazide , metformin , repaglinide , type 2 diabetes , intensive care medicine , insulin , oral hypoglycemic agents , endocrinology , adverse effect
It is obligatory for all adult Muslims to observe fast during the holy month of Ramadan, but sick individuals including those with diabetes mellitus are exempted from the duty of fasting. Specific medical advice must be provided to individual patients concerning the potential risks they must accept if they decide to fast. Any alteration in medications deemed necessary to provide an effective and safe antidiabetic regimen should be instituted well before the start of Ramadan. Diet-controlled patients and those well controlled on insulin sensitizers have low risk of hypoglycemia and may safely fast with some modification in the timing of the doses. Newer generation sulfonylureas (gliclazide MR and glimepiride) have reasonable safety profile during Ramadan fasting and are economical options for a large number of diabetics worldwide, especially in the developing countries; older, long acting sulfonylureas like glibenclamide and chlorpropamide should be avoided during fasting. Oral DPP-IV inhibitors are important substitutes to sulfonylureas for patients with diabetes mellitus during fasting owing to their glucose-dependent mechanism of action, efficacy, and tolerability. This group of drugs causes a moderate A1c reduction, are weight neutral, and have a very low risk of hypoglycemia. Short-acting insulin secretagogues are an option in the subset of fasting diabetic patients who have predominantly post-prandial hyperglycemia.