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Beshyah, Salem A.. (1395). Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines. , 4(2), 82-87. doi: 10.22038/jfh.2016.7099
Salem A. Beshyah. "Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines". , 4, 2, 1395, 82-87. doi: 10.22038/jfh.2016.7099
Beshyah, Salem A.. (1395). 'Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines', , 4(2), pp. 82-87. doi: 10.22038/jfh.2016.7099
Beshyah, Salem A.. Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines. , 1395; 4(2): 82-87. doi: 10.22038/jfh.2016.7099

Safety of Sodium-Glucose Co-Transporter 2 Inhibitors during Ramadan Fasting: Evidence, Perceptions and Guidelines

Journal of Nutrition,Fasting and Health
مقاله 6، دوره 4، شماره 2، شهریور 2016، صفحه 82-87    اصل مقاله (241.05 K)
نوع مقاله: Review Article
شناسه دیجیتال (DOI): 10.22038/jfh.2016.7099
نویسنده
Salem A. Beshyah*
Consultant Physician and Endocrinologist, Center for Diabetes and Endocrinology, Sheikh Khalifa Medical City, P O Box 59472, Abu Dhabi, United Arab Emirates.
چکیده
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new glucose-lowering therapy for T2DM with documented benefits on blood glucose, hypertension, weight reduction and long term cardiovascular benefit. They have an inherent osmotic diuretic effect and lead to some volume loss and possible dehydration. There is some concern about the safety of using SGLT2 inhibitors in Muslim type 2 diabetes mellitus (T2DM) patients during the fast during Ramadan. Currently, there is a dearth of research data to help guide physicians and reassure patients.  One study confirmed good glycemic control with less risk of hypoglycemia and no marked volume depletion. Data in the elderly and in combination with diuretics are reassuring of their safe to use in Ramadan in general. SGLT2 inhibitor-related diabetic ketoacidosis has not been reported during Ramadan and is unlikely to be relevant. Survey of physicians revealed that the majority felt that SGLT2 inhibitors are generally safe in T2DM patients during Ramadan fasting but should be discontinued in certain high risk patients. Some professional groups with interest in diabetes and Ramadan fasting included SGLT2 inhibitors in their guidelines on management of diabetes during Ramadan. They acknowledged the lack of trial data, recommended caution in high risk groups, advised regular monitoring and emphasized pre-Ramadan patients’ education. In conclusion, currently, knowledge, data and experience with SGLT2 inhibitors in Ramadan are limited. Nonetheless, stable patients with normal kidney function and low risk of dehydration may safely use the SGLT2 inhibitors therapy. Higher risk patients should be observed carefully and managed on individual basis.
کلیدواژه‌ها
SGLT2 inhibitor؛ Type 2 diabetes mellitus Type 1 diabetes؛ Canagliflozin؛ Dapagliflozin؛ Empagliflozin؛ Non-glycemic benefit of SGLT2 inhibitors؛ Blood pressure؛ Elderly؛ Dehydration؛ Diuretics؛ Volume depletion؛ Ketoacidosis؛ Ramadan fasting؛ Ethnicity
مراجع
  1. Azizi F. Islamic fasting and diabetes. J Fasting Health. 2013;1(1):1­5.
  2. Beshyah SA. Fasting during the month of Ramadan for people with diabetes: Medicine and Fiqh united at last. Ibnosina J Med B S 2009;1:58-60.
  3. Gray LJ, Dales J, Brady EM, Khunti K, Hanif W, Davies MJ. Safety and effectiveness of non-insulin glucose-lowering agents in the treatment of people with type 2 diabetes who observe Ramadan: A systematic review and meta-analysis. Diabetes Obes Metab. 2015 Jul;17(7):639-48.
  4. Almalki MH, Alshahrani F. Options for Controlling Type 2 Diabetes during Ramadan. Front Endocrinol (Lausanne). 2016 Apr 18;7:32. doi: 10.3389/fendo.2016.00032. eCollection 2016.
  5. Solini A. Role of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus. Acta Diabetol. 2016 Apr 1. [Epub ahead of print]
  6. Marx N, McGuire DK. Sodium-glucose cotransporter-2 inhibition for the reduction of cardiovascular events in high-risk patients with diabetes mellitus. Eur Heart J. 2016 May 5. pii: ehw110.
  7. Shephard RJ. Maintaining fluid balance during day fasting in the month of Ramadan. In: Hamdi Chtourou (Ed).  Effects of Ramadan Fasting on Health and Athletic Performance. OMICS Group International (2015). Available from: http://www.esciencecentral.org/ebooks/effects-of-ramadan-fasting/pdf/maintaining-fluid-balance.pdf. Accessed 23rd June 2016.
  8. Bragazzi NL Ramadan fasting and chronic kidney disease: A systematic review. J Res Med Sci. 2014;19(7):665-76.
  9. Emami-Naini A, Roomizadeh P, Baradaran A, Abedini A, Abtahi M. Ramadan fasting and patients with renal diseases: A mini review of the literature J Res Med Sci. 2013;18(8):711-6.
  10. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm available from: http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm  [accessed 6/6/2016]
  11. European Medicines Agency. EMA confirms recommendations to minimise ketoacidosis risk with SGLT2 inhibitors for diabetes [Internet], 28 April 2016. Available from http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/SGLT2_inhibitors__20/European_Commission_final_decision/WC500202393.pdf Accessed 5 June 2016
  12. Wan Seman WJ, Kori N, Rajoo S, Othman H, Mohd Noor N, Wahab NA, Sukor N, et al. Switching from sulphonylurea to a sodium-glucose cotransporter2 inhibitor in the fasting month of Ramadan is associated with a reduction in hypoglycemia. Diabetes Obes Metab. 2016 Jun;18(6):628-32.
  13. Beshyah SA, Chaterjee S, Dvies MJ. Use of SGLT2 inhibitors during Ramadan: A survey of physicians' views and practical guidance. Br J Diabetes 2016;16:20-4
  14. Ibrahim M, Abu Al Magd M, Annabi FA, Assaad-Khalil S, Ba-Essa EM, Fahdil I, et al. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Research and Care 2015;3:e000108. doi:10.1136/bmjdrc-2015-000108
  15. International Diabetes Federation and the DAR International Alliance. Diabetes and Ramadan: Practical Guidelines. Brussels, Belgium: International Diabetes Federation, 2016. www.idf.org/guidelines/diabetes-in-ramadan and www.daralliance.org.
  16. Ali S, Davies MJ, Brady EM, Gray LJ, Khunti K, Beshyah SA et al. Guidelines for managing diabetes in Ramadan. Diabet Med 2016; Epub ahead of print.
  17. Beshyah SA, Farooqi MH, Suliman SGI, Benbarka M. Use of sodium-glucose co-transporter 2 inhibitors during the fasting of Ramadan: Is there cause for concern? Ibnosina J Med BS 2016;8(3):81-88.
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