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Glucometabolic Perturbations in Type 2 Diabetes Mellitus and Coronavirus Disease 2019: Causes, Consequences, and How to Counter Them Using Novel Antidiabetic Drugs - The CAPISCO International Expert Panel.

Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Novi Sad, Serbia. Medical Faculty, University of Novi Sad, Novi Sad, Serbia. Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece. Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece. Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates. Medical Research Center, Sultan Qaboos University, Muscat, Oman. Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat, Oman. Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland. Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland. Department of Biochemistry, Mohammed Bin Rashid University, Dubai, United Arab Emirates. IRCCS MultiMedica, Milan, Italy. Clinic of Endocrinology, Ankara Güven Hospital, Ankara, Turkey. Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, Sweden. Unit of Research and International Cooperation, University Hospital of Palermo, Italy. Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, Italy. Department of Endocrinology, Singapore General Hospital, Singapore. Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Slovenia. Department of Endocrinology, Bharti Hospital, Karnal, India. Department of Medicine and Oncology, Semmelweis University, Budapest, Hungary. Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India. Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia. The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates. Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil. Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil. Hospital Israelita Albert Einstein, Sao Paulo, Brazil. Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, Bucharest, Romania. Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Diabetes Research Centre, Chennai, India. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), School of Medicine, University of Palermo, Italy.

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2023;(5):260-267
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Abstract

The growing amount of evidence suggests the existence of a bidirectional relation between coronavirus disease 2019 (COVID-19) and type 2 diabetes mellitus (T2DM), as these two conditions exacerbate each other, causing a significant healthcare and socioeconomic burden. The alterations in innate and adaptive cellular immunity, adipose tissue, alveolar and endothelial dysfunction, hypercoagulation, the propensity to an increased viral load, and chronic diabetic complications are all associated with glucometabolic perturbations of T2DM patients that predispose them to severe forms of COVID-19 and mortality. Severe acute respiratory syndrome coronavirus 2 infection negatively impacts glucose homeostasis due to its effects on insulin sensitivity and β-cell function, further aggravating the preexisting glucometabolic perturbations in individuals with T2DM. Thus, the most effective ways are urgently needed for countering these glucometabolic disturbances occurring during acute COVID-19 illness in T2DM patients. The novel classes of antidiabetic medications (dipeptidyl peptidase 4 inhibitors (DPP-4is), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose co-transporter-2 inhibitors (SGLT-2is) are considered candidate drugs for this purpose. This review article summarizes current knowledge regarding glucometabolic disturbances during acute COVID-19 illness in T2DM patients and the potential ways to tackle them using novel antidiabetic medications. Recent observational data suggest that preadmission use of GLP-1 RAs and SGLT-2is are associated with decreased patient mortality, while DPP-4is is associated with increased in-hospital mortality of T2DM patients with COVID-19. Although these results provide further evidence for the widespread use of these two classes of medications in this COVID-19 era, dedicated randomized controlled trials analyzing the effects of in-hospital use of novel antidiabetic agents in T2DM patients with COVID-19 are needed.

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Publication Type : Review

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