SynthesisJournal of diabetes research2022
Safety Assessment of Glucose-Lowering Drugs and Importance of Structured Education during Ramadan: A Systematic Review and Meta-Analysis.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims - A Randomised Controlled Trial.International journal of behavioral medicine · 2025Trial
- Religiosity and Adherence to Pharmacotherapy for Type 2 Diabetes Mellitus among the Elderly in Primary Healthcare Centres in Brazil.Journal of religion and health · 2026Article
- [Diabetes and migration - Recommendations for the practice (Update 2026)].Wiener klinische Wochenschrift · 2026Article
- Protective Effects of Isolated Curcumin FromJournal of diabetes research · 2025Article
- Diabetes management during and after Ramadan among pregnant women in Saudi Arabia: exploring self-efficacy, self-care, and glycemic control.Frontiers in nutrition · 2025Article
- As a phenomenon: Ramadan fasting improves olfactory performance.Laryngoscope investigative otolaryngology · 2024Article
- Real-world evidence on the effectiveness and safety of gliclazide MR 60 mg in Bangladeshi patients with Type II diabetes during fasting: a sub-analysis from the global DIA-RAMADAN study.Journal of comparative effectiveness research · 2024Observational
- Expert eValuation of Efficacy and Rationality of Vildagliptin "EVER-Vilda": An Indian Perspective.Clinical medicine insights. Endocrinology and diabetes · 2024Article
- Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes.International journal for equity in health · 2023Review
- Glucagon-Like Peptide-1 (GLP-1) during Ramadan: Narrative Review of the Published Literature.Journal of obesity · 2023Review
- [Diabetes and migration (update 2023)].Wiener klinische Wochenschrift · 2023Article
- Diabetes Patients' Acceptance of Injectable Treatment, a Scientometric Analysis.Life (Basel, Switzerland) · 2022Review
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRamadan is the sacred month of the Islamic Hijri (lunar) calendar, and during this entire month, healthy adult Muslims abstain from eating and drinking from dawn to sunset. Muslims with Type 2 Diabetes Mellitus (T2DM) who choose to fast during Ramadan encounter major risks such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration, and thrombosis. Although patients with poor glycemic control and on multiple insulin injections are at high risk and exempt from fasting, many still insist on it. Thus, healthcare professionals play a pivotal role in managing diabetes-related complications in patients who fast during Ramadan. However, there is a lack of standard guidelines to be followed in association with structured education and administration of drugs and dosage. Therefore, we performed a systematic review and meta-analysis of the literature to determine the safety and efficacy of different classes of drugs and the importance of structured education during Ramadan.
methodsIn this review, an extensive PubMed search was performed to obtain literature on T2DM patients who fast during the month of Ramadan until the year 2020. Preference was given to fully downloadable articles. The articles were extracted based on the eligibility criteria. The extracted data were analyzed using Review Manager software version 5.3.
resultsA total of 32 articles were included for the review and 7 studies for meta-analysis. Majority of the studies demonstrated the importance of structured education either as a group session or as a one-on-one session with the healthcare professionals in preventing diabetes-related risks during Ramadan. As far as glucose-lowering drugs are concerned, DPP-4 inhibitor combined with metformin remains the drug of choice for T2DM patients who fast during Ramadan. The newer class of glucose-lowering agents appear to lower the risk of hypoglycemia in comparison with sulphonylureas, while among sulphonylureas gliclazide is relatively safe. The meta-analysis indicates that DPP-4 inhibitors would significantly reduce the risk of hypoglycemia as compared to sulphonylurea (odds ratio = 0.38, 95% CI: 0.26 to 0.55,
conclusionThe results of our systematic review show that structured education and counselling by healthcare professionals can be an effective tool in preventing complications associated with fasting during Ramadan in people with T2DM. Additionally, the safest class of oral glucose-lowering drugs preferred during Ramadan fasting in T2DM patients is DPP-4 inhibitors.
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