Diabetes and COVID-19

Abstract

According to previous reports, diabetes seems to be a risk factor which worsens the serious clinical events caused by COVID-19. But is diabetes per se a risk factor that increases the probability of getting the virus? This paper will discuss this point. There are not many research data on antidiabetic drugs in this context. The potential influence of glucose-lowering agents on the severity of COVID-19 has not been described yet. Dipeptidylpeptidase-4 (DPP-4) is a cell surface protein ubiquitously expressed in many tissues and it is also a soluble molecule found in serum/plasma fluids. DPP-4 is involved in infection of cells by some viruses. This paper reviews data about the use of DPP-4 inhibitors and others diabetes drugs on COVID-19 patients. As such, no available evidence has yet suggested that glucose-lowering drugs -including those targeting DPP4-related pathways -produce any significant harm or benefit in the context of human infections. However, insulin must remain the first-choice agent in the management of critically ill-hospitalized patients, while it is recommended to suspend other agents in unstable patients. This paper provides related French and international recommendations for people with diabetes who got infected by COVID-19 and upholds that infections may alter glucose control and may require additional vigilance.

A meta-analysis on the preadmission use of DPP-4 inhibitors and risk of a fatal or severe course of illness in patients with COVID-19

“…We read with interest the review by Bouhanick et al [1] which discussed the association between diabetes mellitus and coronavirus disease 2019 (COVID-19). Particularly, the authors have summarized the available evidence on the use of several classes of glucose-lowering agents in patients with COVID-19, and they postulated that dipeptidyl peptidase-4 (DPP-4) inhibitors could influence the course of COVID-19 via their anti-inflammatory actions.…”

DPP-4 inhibitors and severe course of illness in patients with COVID-19

“…In 2020, we reported research data on antidiabetic drugs in this context and the potential influence of dipeptidyl peptidase-4 (DPP-4) inhibitors [1] . DPP-4 inhibitors target the enzymatic activity of DPP-4 and block the breakdown of GLP-1 and GIP leading to increased insulin secretion and reduced hyperglycemia in patients with type 2 diabetes.…”

DPP-4 Inhibitors in the Prevention/Treatment of Pulmonary Fibrosis, Heart and Kidney Injury Caused by COVID-19—A Therapeutic Approach of Choice in Type 2 Diabetic Patients?

“…The potential role of DPP-4 in the pathogenesis of COVID-19 is a subject of the ongoing debate. Various authors emphasized anti-inflammatory properties of DPP-4 inhibitors with conflicting opinions on whether these effects are beneficial or detrimental in patients with COVID-19 ( Bouhanick et al., 2020 ; Chen C. F. et al., 2020 ; Dalan, 2020 ; Drucker, 2020 ; Iacobellis, 2020 ; Kokic Males, 2020 ; Pinheiro et al., 2020 ). In addition, Strollo and Pozzilli (2020) pointed to well-known anti-fibrotic activity, while Bassendine et al.…”