Comparison of the effectiveness of different oral glucose lowering drugs in fasting patients with type II diabetes

Type 2 diabetes is the most common metabolic diseases in developed and developing countries with no effective treatment options. This study purpose was to compare different regimens of oral anti-diabetic therapy effects on the type 2 diabetic patients while fasting during Ramadan. In the double-blind controlled trial 90 patients with type 2 diabetes were divided randomly into three groups: 30 patients continued the previous dose of sulfonylurea (Group 1), 30 participants received a dose which was 25% lower than the previous sulfonylurea dose (group 2), and in the last 30 patients, repaglinide was replaced sulfonylurea (Group 3). Glucose, glycosylated hemoglobin (HbA1C), fructosamine, total cholesterol, low-density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides levels were measured in all participants before and after Ramadan. The weight and BMI were also controlled. In all intervention groups a significant decreasing was seen in the body weight, BMI, fructoseamine, total cholesterol, and LDL; and also, a significant increasing was seen in HDL. The hypoglycemia incidence was significantly lower in Group 3 than Group 1. The results in fructosamine reduction and HDL cholesterol increasing were significantly better in Group 3 compared to Group 2 (P<0.05). Significant changes were not seen in total cholesterol, LDL, triglyceride, FBS, and HbA1C levels among the three treatment groups during Ramadan. The repaglinide consumption in comparing with sulfonylurea in patients with diabetes during Ramadan can cause fewer hypoglycemia, and better glycemic, and lipid control.