China: A recent study in the journal Frontiers in Endocrinology has suggested that metformin and sulfonylurea may reduce mortality risk in patients with type 2 diabetes affected by COVID-19. Further, it was found that insulin use could be related to greater mortality while not the use of DPP-4 inhibitor.
Coronavirus disease 2019 (COVID-19) is a serious global health problem that has affected more than 100 million people worldwide (as of January 26, 2021). Previous studies have reported in-hospital mortality of 29% in patients with diabetes or hyperglycemia compared with 6% among people without diabetes or hyperglycemia indicating a fourfold increase in COVID-19 mortality in them.
Chengxia Kan, Department of Endocrinology, Affiliated Hospital of Weifang Medical University, Weifang, China, and colleagues conducted a systematic review and meta-analysis to assess various antidiabetic agents' association with mortality in patients with type 2 diabetes (T2DM) who have COVID-19.
The researchers performed comprehensive literature retrieval from the date of inception until February 2, 2021, in medical databases regarding mortality outcomes in patients with T2DM who have COVID-19.
Eighteen studies with 17,338 patients were included in the meta-analysis.
The research yielded the following findings:
Metformin (pooled OR, 0.69) and sulfonylurea (pooled OR, 0.80) were associated with lower mortality risk in patients with T2DM who had COVID-19.
However, patients with T2DM who had COVID-19 and received insulin exhibited greater mortality (pooled OR, 2.20).
Mortality did not significantly differ (pooled OR, 0.72) between DPP-4 inhibitor users and non-users.
"The results of this meta-analysis should be interpreted carefully because of the limitations of included studies, although the effects of sulfonylurea and DPP-4 inhibitors should be more fully evaluated in subsequent studies," the researchers wrote. "Further larger trials should also be done to confirm these results and especially other diabetes drugs including SGLT2 inhibitors and DPP-4 inhibitors."
Reference:
Kan C, Zhang Y, Han F, Xu Q, Ye T, Hou N and Sun X (2021) Mortality Risk of Antidiabetic Agents for Type 2 Diabetes With COVID-19: A Systematic Review and Meta-Analysis. Front. Endocrinol. 12:708494. doi: 10.3389/fendo.2021.708494