Recently it has been hypothesized that DPP4 inhibitors can have a beneficial effect on SARS-CoV-2 infection through immunoregulating activity.Experimental study on streptozotocintreated rats showed that liraglutide was able to stimulate the expression of pulmonary angiotensin converting enzyme 2 (ACE2) and angiotensin (1-7).Liraglutide modulated different elements of the renin angiotensin system (RAS), significantly increasing ACE2 and Mas receptor (MasR) mRNA expression in pup lungs from food-restricted mothers. Some action mechanisms support the hypothesis of a protective action of GLP-1R agonists, capable of mitigating a more serious clinical course among SARS-CoV-2-infected individuals with T2DM.Type 2 diabetes mellitus (T2DM) represents an important risk factor for a more severe evolution associated with higher lethality of the infection from the new coronavirus disease 2019 (COVID-19; caused by severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), responsible for the current pandemic that originated from the epidemic which initially affected the Wuhan region in China in December 2019 [1]. SARS-CoV-2 uses as a receptor for the infection of respiratory epithelial cells-the angiotensinconverting enzyme 2 (ACE2) receptor [1]; this was also the case for SARS coronavirus (SARS-CoV), responsible for the epidemic that affected more than 8000 people mainly in Asia during the 2002-2003 period [2]. In contrast, Middle East respiratory syndrome (MERS) coronavirus, which caused (as of November 2019) 2494 confirmed cases of infection reported to the World Digital Features To view digital features for this article go to

After examining the complex interplay between heart failure (HF) in its various clinical forms, metabolic disorders like nonalcoholic fatty liver disease (NAFLD), and obstructive sleep apnea (OSA) syndrome, in this mini-review we described possible favorable effects of sodium-glucose cotransporter 2 inhibitors (SGLT2is) on HF with preserved (i.e., C 50%) ejection fraction (HFpEF) through enhanced cardiorenal function and visceral-subcutaneous body fat redistribution. In greater detail, on the basis of pathophysiological mechanisms underlying OSA onset and the direct positive SGLT2i effect on renal function benefiting chronic kidney disease, we emphasized the promising role of SGLT2is in prevention, rehabilitation, and treatment of patients with OSA regardless of coexisting type 2 diabetes (T2DM). Indeed, SGLT2is enhance lipolysis and fatty acid beta-oxidation. These phenomena might prevent OSA by reducing the size of visceral and subcutaneous

Obstructive sleep apnoea (OSA) is characterized by frequent apnoea episodes during sleep due to upper airway obstruction. The present review summarizes current knowledge on inter-relationships between OSA and type 2 diabetes mellitus (T2DM) and suggests the former as a possible target for sodium-glucose co-transporter-2 inhibitors (SGLT-2i). Based on pathophysiological mechanisms underlying OSA onset and renal SGLT-2 effects, we suggest that SGLT-2i indications might expand beyond current ones, including glucose, lipids, uric acid, blood pressure, and body weight control as well as chronic heart failure and kidney disease prevention.

The Coronavirus Pandemic has forced millions of people around the world to look at home. This resulted, as a consequence, in a remodelling of the lifestyle; in this scenario the correct nutrition combined with regular physical activity becomes fundamental for health. Although the sedentary lifestyle of a few weeks involves risks such as lowering the immune system, it favours overweight and obesity, high blood pressure, metabolic disorders, depression and anxiety, and in some subjects they react to the risk of onset of cardiovascular disease, diabetes and other diseases. The importance of healthy lifestyle is crucial to prevent also viral infection. Indeed, as reported by many data literature, during lung infections, IL-6 and TNF-a create the pathway between adipose tissue and lung system demonstrating the important involvement of adipose tissue in lung diseases. In obese condition, adipose tissue endocrine function is altered. There is an imbalance in the production of pro-inflammatory cytokines such as IL-6 and TNF-a and anti-inflammatory mediators such as IL-10. In the light of these evidences, the immune response is influenced by nutritional status and by physical activity which are able to reduce proinflammatory mediators and increase anti-inflammatory mediators such as IL-10 . In addition, the power of viral infection is influenced by host predisposition. For these reasons, a correct lifestyle, and physical activity are a valid strategy in the prevention and treatment of not metabolic diseases also of inflammatory diseases.

Our data from the daily clinical practice add up and confirm the information available on the association between incretin-mimetics and pancreatic damage and suggest caution in the prescribing of these new drugs and a close monitoring of exposed patients.