title: Switching from sulphonylurea to a sodium-glucose cotransporter2 inhibitor in the fasting month of Ramadan is associated with a reduction in hypoglycaemia.
abstract: The aim of the present study was to assess the hypoglycaemia risk and safety of dapagliflozin compared with sulphonylurea during the fasting month of Ramadan. In this 12-week, randomized, open-label, two-arm parallel group study, 110 patients with type 2 diabetes who were receiving sulphonylurea and metformin were randomized either to receive 10 mg (n = 58) of dapagliflozin daily or to continue receiving sulphonylurea (n = 52). The primary outcome was to compare the effects of dapagliflozin and sulphonylurea on the proportions of patients with at least one episode of hypoglycaemia during Ramadan, as well as to assess the safety of dapagliflozin when used to treat patients observing Ramadan. A lower proportion of patients had reported or documented hypoglycaemia in the dapagliflozin group than in the sulphonylurea group: 4 (6.9%) versus 15 (28.8%); p = 0.002. The relative risk of any reported or documented hypoglycaemia in the 4th week of Ramadan was significantly lower in the dapagliflozin group: RR=0.24, 95%CI: 0.09, 0.68; p=0.002. No significance differences were observed between the two groups regarding postural hypotension (13.8 vs 3.8%; p = 0.210) or urinary tract infections (10.3 vs 3.8%; p = 0.277). In conclusion, fewer patients exhibited hypoglycaemia in the dapagliflozin group than in the sulphonylurea group.
authors.affiliation: Endocrine Unit, Department of Medicine, Putrajaya Hospital, Putrajaya, Malaysia.
authors.forename: W J
authors.initials: WJ
authors.lastname: Wan Seman
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Kori
authors.affiliation: Endocrine Unit, Department of Medicine, Putrajaya Hospital, Putrajaya, Malaysia.
authors.forename: S
authors.initials: S
authors.lastname: Rajoo
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: H
authors.initials: H
authors.lastname: Othman
authors.affiliation: Endocrine Unit, Department of Medicine, Putrajaya Hospital, Putrajaya, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Mohd Noor
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N A
authors.initials: NA
authors.lastname: Wahab
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Sukor
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Mustafa
authors.affiliation: Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N A
authors.initials: NA
authors.lastname: Kamaruddin
mesh_terms: D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D057915:Drug Substitution / Q000379:methods*; D004359:Drug Therapy, Combination; D005215:Fasting / Q000097:blood; D005260:Female; D005960:Glucosides / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007514:Islam; D008297:Male; D008687:Metformin / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013453:Sulfonylurea Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013453:Sulfonylurea Compounds; C529054:dapagliflozin; D008687:Metformin
keywords: SGLT2 inhibitor; dapagliflozin; hypoglycaemia; sulphonylurea