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: Causes, Consequences, and How to Counter Them Using Novel Antidiabetic Drugs – The CAPISCO International Expert Panel

Djordje S. Popovic*, Nikolaos Papanas, Theocharis Koufakis, Kalliopi Kotsa, Wael Al Mahmeed, Khalid Al-Rasadi, Kamila Al-Alawi, Maciej Banach, Yajnavalka Banerjee, Antonio Ceriello, Mustafa Cesur, Francesco Cosentino, Alberto Firenze, Massimo Galia, Su Yen Goh, Andrej Janez, Sanjay Kalra, Peter Kempler, Nitin Kapoor, Nader LessanPaulo Lotufo, Ali A. Rizvi, Amirhossein Sahebkar, Raul D. Santos, Anca Pantea Stoian, Peter P. Toth, Vijay Viswanathan, Manfredi Rizzo

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)

Abstract

The growing amount of evidence suggests the existence of a bidirectional relation between coronavirus disease 2019 (COV-ID-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.

Original languageEnglish
Pages (from-to)260-267
Number of pages8
JournalExperimental and Clinical Endocrinology and Diabetes
Volume131
Issue number5
Early online dateJan 24 2023
DOIs
Publication statusPublished - May 2023

Keywords

  • glucagon-like peptide-1 receptor agonist
  • coronavirus disease 2019
  • sodium-glucose co-transporter-2 inhibitor
  • type 2 diabetes mellitus
  • dipeptidyl peptidase 4 inhibitor
  • COVID-19/complications
  • Humans
  • Glucose
  • Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
  • Diabetes Mellitus, Type 2/complications
  • Glucagon-Like Peptide 1/therapeutic use
  • Hypoglycemic Agents/pharmacology
  • Dipeptidyl-Peptidase IV Inhibitors/therapeutic use

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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