Objective: to assess safety and efficacy of the available oral anti diabetic Drugs during Ramadan 2016 in Sohag Governorate .
Methodology: This study was conducted on 90 type II Diabetic patients attending to outpatient Endocrinology clinic in Sohag University Hospital, on oral treatment classified into 5groups,as following , 20 (22.22%)patients on Metformin(Group I),30 (33.33%)patients on Sulphonylureas with or without metformin(Group II), 18 (20%) patients on Dipeptidyl peptidase-4 inhibitors with or without metformin (Group III),12 (13.33% ) patients on Thiazolidinedoines with or without metformin (Group V),10 (10%) patients on combinations of more than two drugs (Group VI), Mean age of patients is 59.93±7.87years, (61.11%)of them were females,(38.89%) of them were male patients and Mean duration of diabetes is 4.52±2.45(range 1:10).follow up of the patient was done by Wight changes, measuring blood sugar ,asses Hba1c ,and renal function also was done before and during ramadan.
Results:  In this  study we found a significant decrease in Hba1c after Ramadan with Group III (DPP4I) compared  with other Groups also we found the number of hypoglycemic episodes of all groups about 10 (11.11%), more with Group II (SUs) about (9) patients developed hypoglycemia of whom 30, compared with other groups while lower number of hypoglycemia was found with Group III (DPP4I),about one patient developed hypoglycemia, also we found  the number of non fasted days more with SUs,(range 2-10) also we found no body weight changes more with Group III (DPP4I) while body weight gain occurred with Group II (SUs) about 1-4Kgs .
In conclusion, Ramadan represents one of challenging issues for health care providaers  all over the world . DPP4 inhibitors may considered favorable for use during and after Ramadan due to their lower rate of hypoglycemic events and weight neutral/loss effect during and after Ramadan .