Table 2.

Studies primarily focusing on Dipeptidyl peptidase-4 inhibitors (DPP-4i) use in Ramadan. The number in the parenthesis is reference

No	Drug DPP-4i	Trial	Main findings
1.	Vildagliptin [41]	Vildagliptin vs sulfonylurea in Indian Muslim diabetes patients fasting during Ramadan	Higher percentage of vildagliptin-treated patients achieved HbA1c compared with sulfonylurea. Mean decrease in the body weight was 1.2 kg and 0.03 kg, respectively (P < 0.001)
2.	Vildagliptin [42]	Effect of Vildagliptin Versus Sulfonylurea in Muslim Patients with Type 2 Diabetes Fasting During Ramadan in Egypt	Treatment with vildagliptin was associated with lower incidence of hypoglycemia compared with SU and showed good glycemic and weight control in patients with T2DM fasting during Ramadan
3.	Vildagliptin [43]	Glycemic effects of vildagliptin in patients with type 2 diabetes before, during and after the period of fasting in Ramadan	Change in hemoglobin A1c from baseline to last visit was similar for both groups. The incidence of hypoglycaemia during Ramadan was higher in the control. This result was not statistically significant. However, the number of patients who dropped out from the was higher in the control group
4.	Vildagliptin [44]	Effects of Vildagliptin relative to sulfonylureas in Muslim patients with type 2 diabetes fasting during Ramadan: influence of age and treatment with/without metformin in the VIRTUE study	A few patients experienced hypoglycemic episodes with vildagliptin vs SUs. Vildagliptin ± metformin was also associated with good glycemic and weight control and was well tolerated. Vildagliptin might be a useful treatment option for patients with type 2 diabetes mellitus, particularly high-risk populations such as the elderly fasting during Ramadan
5.	Vildagliptin [45]	Experience with Vildagliptin in Type 2 Diabetic Patients Fasting During Ramadan in France: Insights from the VERDI Study	Although the overall frequency of malaise suggestive of hypoglycemia was high, which would be expected with prolonged fasting in a well-controlled T2DM population during hot summer days, the incidence of more severe and better-documented episodes were much lower, with consistently less events with vildagliptin therapy
6.	Vildagliptin [46]	Vildagliptin therapy and hypoglycaemia in Muslim type 2 diabetes patients during Ramadan	The addition of vildagliptin to metformin therapy during Ramadan in Muslim patients with type 2 diabetes was associated with a reduction in the incidence of hypoglycaemia
7.	Vildagliptin [47]	Comparison vildagliptin and the sulphonylurea gliclazide in combination with metformin, in Muslim patients with type 2 diabetes mellitus fasting during Ramadan: results of the VECTOR study	Vildagliptin caused no hypoglycaemia, was well adhered to and improved HbA 1c, making it a suitable treatment option for managing fasting
8.	Vildagliptin [48]	A double-blind, randomized trial, including frequent patient-physician contacts and Ramadan-focused advice, assessing vildagliptin and gliclazide in patients with type 2 diabetes fasting during Ramadan: the STEADFAST study	vildagliptin was shown to be an effective, safe, and well-tolerated treatment in patients with T2DM fasting during Ramadan, with a consistently low incidence of hypoglycemia across studies, accompanied by good glycemic and weight control
9.	Vildagliptin [49]	The effect of vildagliptin relative to sulfonylurea as dual therapy with metformin (or as monotherapy) in Muslim patients with type 2 diabetes fasting during Ramadan in the Middle East: the VIRTUE study	Anti-hyperglycemic treatment with vildagliptin led to significantly fewer hypoglycemia events compared and good weight control compared to sulfonylurea treatment among Muslim diabetic patients who fast during Ramadan
10.	Vildagliptin [50]	The effect of vildagliptin relative to sulphonylureas in Muslim patients with type 2 diabetes fasting during Ramadan: the VIRTUE study	vildagliptin was well tolerated and associated with significantly fewer hypoglycaemic episodes compared with SU therapy