J. Belkhadir et al., MUSLIMS WITH NON-INSULIN-DEPENDENT DIABETES FASTING DURING RAMADAN - TREATMENT WITH GLIBENCLAMIDE, BMJ. British medical journal, 307(6899), 1993, pp. 292-295
Objective-To compare the efficacy of two glibenclamide regimens in pat
ients with non-insulin dependent diabetes who were fasting during Rama
dan and regular glibenclamide treatment in the non-fasting group. Desi
gn-Non-randomised control group of patients who did not fast during Ra
madan and two groups of patients who fasted randomised equally to one
of two regimens: to take their usual morning dose of glibenclamide in
the evening and their usual evening dose before dawn; or to follow thi
s pattern but to reduce the total dose by a quarter. Setting-Two unive
rsity hospitals, one private hospital, and two private clinics in Casa
blanca and Rabat, Morocco. Subjects-591 diabetic patients (198 men, 39
1 women, two unspecified) with similar duration of diabetes and length
and amount of glibenclamide treatment, of whom 542 completed the stud
y. Main outcome measures-Serum fructosamine and total glycated haemogl
obin concentrations and number of hypoglycaemic events. Results-At the
end of Ramadan there were no significant differences between the grou
ps in fructosamine concentration (400 mumol/l in controls and 381 mumo
l/l and 376 mumol/l in the fasting groups); percentage of glycated hae
moglobin (14.7%, 14.0%, and 13.6%); or number of hypoglycaemic events
during Ramadan (11, 14, and 10). Conclusion-Glibenclamide is effective
and safe for patients with non-insulin dependent diabetes who fast du
ring Ramadan. The easiest regimen is to take the normal morning dose (
together with any midday dose) at sunset and any evening dose before d
awn.