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            A           HbA 1c                  FPG            5.    Conclusion
                        Change:                Change:
                       -0.3±0.8%             -9.7±43.6 mg/dL   This is the first real-world study to show that patients with
                9       p<0.001      210       p<0.001         T2DM treated with gliclazide MR without dose adjustment
               8.5                   190                       during Ramadan can fast safely with a low risk of hypogly-
                8                    170                       caemia and no risk of severe hypoglycaemia, even in pro-
              (%)  7.5               150                       longed fasting period, whilst maintaining glycaemic control
              HbA 1c  6.5 7         FPG (mg/dL)  130           and weight.
                                     110
                6                     90                       6.    Contribution statement
               5.5   7.5      7.2     70   140.3    130.2
                5                     50                       Mohamed Hassanein served as the international coordinator
                   V0 (n=942)  V1 (n=973)  V0 (n=961)  V1 (n=972)  for the study. All remaining authors served as coordinators
                         Visit                  Visit
            B  60                                              at the national level. All authors participated in the prepara-
                                                               tion of the manuscript and approved the final version for
               50                                   V0  V1
              )                                                publication.
              %
              (

              s
              t  40
              n
              e
              i                                                Acknowledgements
              t
              a
              p  30

              f
              o

              n                                                Medical writing support was provided by Physicians World
              o  20
              i
              t
              r                                                Europe GmbH, Mannheim, Germany, and was funded by
              o
              p
              o  10                                            Servier.
              r                                       3.0
              P     42.7 50.9  18.9 15.0  29.0 11.2  2.6
                0
                   n=518/618  n=230/182  n=352/136  n=32/37    Funding
                      <7.5   ≥7.5 to <8.0  ≥8.0 to <9.0  ≥9.0
                                  HbA 1c groups                This study was sponsored by Servier (Servier Affaires
            C         Body weight               BMI            Me ´dicales).
                        Change:                Change:
                       -0.5±3.9 kg           -0.2±1.5 kg/m 2   Data sharing statement
              100       p<0.001       40       p<0.001
                                                               The datasets used and/or analysed during the current study
               90                     35                       are available from the corresponding author upon reasonable
             (kg)   80                30                       request.
             Weight  70             BMI (kg/m 2 )  25          Declaration of competing interests
               60                     20                       Achmad Rudijanto has received research grants from Novo
                     76.5    76.1           28.4     28.2
               50                     15                       Nordisk, Sanofi-Aventis, and Servier; Advisory board fees
                  V0 (n=1,189) V1 (n=1,120)  V0 (n=1,159) V1 (n=1,091)  from Sanofi-Aventis, Astra Zeneca, Novo Nordisk, Ely Lilly,
                         Visit                   Visit         and Novartis. Mohamed Hassanein has attended advisory
                                                               boards or received speaker honoraria from Servier, MSD,
           Fig. 3 – HbA 1c , FPG, body weight and BMI values at V0 and
                                                               Novartis, Novo Nordisk, Sanofi-Aventis, Astra Zeneca and Eli
           V1. (A) Mean HbA 1c and FPG values at V0 and V1. (B)
                                                               Lilly. Syed Abbas Raza has participated in advisory boards
           Proportion of patients within specified HbA 1c range at V0
                                                               for Sanofi-Aventis, Novo Nordisk, Servier and Ely Lilly. Tha-
           and V1. (C) Mean body weight and BMI values at V0 and V1.
                                                               mer Alessa has received research grants from Servier; Advi-
           Error bars show ± SD. Significance values for changes
                                                               sory Board fees from Sanofi-Aventis, Astra Zeneca, Novo
           between V0 and V1 were calculated using the student’s t
           test for HbA 1c and FPG, and the rank signed test for body  Nordisk, Ely Lilly, and Novartis; Honoraria from Sanofi-
                                                               Aventis, Astra Zeneca, Servier, Novo Nordisk, Ely Lilly, and
           weight and BMI. Mean change was calculated from patients
           with values available at V0 and V1 (HbA 1c [n = 942], FPG  Novartis. Wan Mohd Izani Wan Mohamed has received
                                                               research grants Sanofi Aventis, Novartis, GSK, Novo Nordisk,
           [n = 845], body weight [n = 1,115], and BMI [n = 1,089]). BMI,
           body mass index; FPG, fasting plasma glucose; HbA 1c ,  Lilly, Servier, Astra Zeneca, BI, Takeda, MSD, Bayer, and J&J;
                                                               Speaker honoraria from Novo Nordisk, Lilly, GSK, Sanofi,
           glycated haemoglobin; SD, standard deviation.
                                                               Novartis, MSD, Astra Zeneca, Servier, Merck, BioRad and Che-
                                                               mopharm. Shehla Shaikh has received advisory board fees
                                                               and speaker honoraria from Novo Nordisk, Eli Lilly, Novartis,
           (99.5%). Furthermore, the majority of patients (95.6%) who  Sanofi-Aventis, MSD and Servier. Inass Shaltout has been a
           attended the inclusion visit (V0) also attended the end-of-  speaker and advisor to Sanofi, Novartis, MSD, Astra Zeneca,
           study visit (V1), and only few data were missing considering  Novo Nordisk, Lilly, Servier, Takeda and Hekma. Agung Pran-
           the observational nature of the study.              oto has received research grants from Novo Nordisk and Ser-
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