title: A comparison of glycemic effects of glimepiride, repaglinide, and insulin glargine in type 2 diabetes mellitus during Ramadan fasting.
abstract: Although diabetics may be exempted from Ramadan fasting, many patients still insist on this worship. Aim of the present study is to compare the effects of glimepiride, repaglinide, and insulin glargine in type 2 diabetics during Ramadan fasting on the glucose metabolism. Patients, who were willing to fast, were treated with glimepiride (n=21), repaglinide (n=18), and insulin glargine (n=10). Sixteen non-fasting control type 2 diabetics matched for age, sex, and body mass index were also included. Fasting blood glucose (FBG), post-prandial blood glucose (PBG), HbA1c, and fructosamine as well as lipid metabolism were evaluated in pre-Ramadan, post-Ramadan, and 1-month post-Ramadan time points. There was no significant change from pre-Ramadan in FBG, PBG, and HbA1c variables in fasting diabetics at post-Ramadan and 1-month post-Ramadan. However, PBG was found higher in non-fasting control diabetics at post-Ramadan and 1-month post-Ramadan (p<0.05 and p<0.001, respectively). In fructosamine levels, a significant increase was noted both in fasting group and non-fasting group at 1-month post-Ramadan (p<0.01 for all). However, no significant difference was found in the comparison of the changes in fructosamine levels between fasting group and non-fasting group. Risk of hypoglycemia did not significantly differ between fasting and non-fasting diabetics. There was no significant difference between three drug therapies regarding glucose metabolism and rate of hypoglycemia. No adverse effects on plasma lipids were noted in fasting diabetics. In this fasting sample of patients with type 2 diabetes, glimepiride, repaglinide, and insulin glargine did not produce significant changes in glucose and lipid parameters.
authors.affiliation: Ankara Guven Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cesur
authors.forename: Demet
authors.initials: D
authors.lastname: Corapcioglu
authors.forename: Alptekin
authors.initials: A
authors.lastname: Gursoy
authors.forename: Sait
authors.initials: S
authors.lastname: Gonen
authors.forename: Mine
authors.initials: M
authors.lastname: Ozduman
authors.forename: Rifat
authors.initials: R
authors.lastname: Emral
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Uysal
authors.forename: Vedia
authors.initials: V
authors.lastname: Tonyukuk
authors.forename: Arif Ender
authors.initials: AE
authors.lastname: Yilmaz
authors.forename: Fahri
authors.initials: F
authors.lastname: Bayram
authors.forename: Nuri
authors.initials: N
authors.lastname: Kamel
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002219:Carbamates / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005215:Fasting / Q000502:physiology*; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D007514:Islam; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010880:Piperidines / Q000627:therapeutic use*; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D014421:Turkey
chemical_list: D002219:Carbamates; D019270:Fructosamine; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D010880:Piperidines; D013453:Sulfonylurea Compounds; C072379:repaglinide; C057619:glimepiride