SUMMARY
Aim of the study was to evaluate the safety and efficacy of glucose-lowering therapy in patients with type 2 diabetes mellitus (T2DM) fasting during Ramadan in Azerbaijan. Material and methods. The study was conducted at Baku Medical Plaza Hospital. A total of 123 patients were enrolled, and 4 were subsequently excluded; therefore, the final analysis included 119 participants. The main group consisted of 68 patients receiving DPP-4 inhibitors, while the control group included 51 patients not treated with these agents. Anthropometric measurements, blood pressure assessment, and laboratory investigations were performed in all participants. Results. The results demonstrated that HbA1c ≥9.0%, insulin therapy, sulfonylurea treatment, and an IDF/DAR score >3 were significantly associated with an increased risk of hypoglycemia and severe hypoglycemia. In contrast, the use of DPP-4 inhibitors was associated with a reduced risk of hypoglycemia and was identified as a protective factor. No significant associations were found between hypoglycemia risk and age, sex, duration of diabetes, body weight, arterial hypertension, ALT level, TyG index, TyG×BMI, SHR1, SHR2, or Glycemic Gap. Conclusion. These findings highlight the importance of individualized risk assessment, implementation of the IDF/DAR risk stratification system, and appropriate selection of glucose-lowering therapy to ensure safe fasting during Ramadan in patients with T2DM.
Keywords: type 2 diabetes mellitus, Ramadan, fasting, hypoglycemia, DPP-4 inhibitors, insulin therapy, IDF/DAR score

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