Potential Therapeutic Benefits of Metformin Alone and in Combination with Sitagliptin in the Management of Type 2 Diabetes Patients with COVID-19.
Hayder M Al-KuraishyAli I Al-GareebSarah M AlbogamiJean Marc SabatierEman Hassan NadwaAmin A HafizWalaa A NegmMarwa KamalMohammed Al-JoubouryEngy ElekhnawyGaber El-Saber BatihaMichel De WaardPublished in: Pharmaceuticals (Basel, Switzerland) (2022)
Type 2 diabetes mellitus (T2DM) is a potential risk factor for the development of COVID-19 and is associated with higher severity and mortality rates. T2DM patients are commonly treated with metformin monotherapy or metformin plus sitagliptin. In the present case-control, single-center cohort study, a total number of 112 T2DM patients suffering from COVID-19 and aged 44-62 years old were compared with 78 T2DM patients without COVID-19 and aged 42-56 years old. Both the patient group and the control group were allocated into four groups. Group A: T2DM patients with COVID-19 on metformin treatments plus standard therapy ( n = 60); group B: T2DM patients with COVID-19 on metformin plus sitagliptin plus standard therapy ( n = 52); group C: T2DM patients without COVID-19 on metformin treatments ( n = 40); and group D: T2DM patients without COVID-19 on metformin plus sitagliptin ( n = 38). The investigation duration was 2-3 weeks. Anthropometric measurements, serological and biochemical investigations, pulmonary radiological findings, and clinical outcomes were evaluated. Only 101 T2DM patients with COVID-19 continued the study, 71 (70.29%) with mild-moderate COVID-19 and 30 (29.7%) with severe COVID-19 were compared with 78 T2DM patients as a control. Inflammatory biomarkers (C reactive protein, ferritin, and procalcitonin), a lung injury biomarker (lactate dehydrogenase), and a coagulopathy biomarker (D-dimer) were elevated in severe COVID-19 patients compared with mild-moderate COVID-19 ( p < 0.05) and T2DM patients ( p < 0.05). However, metformin plus sitagliptin was more effective than metformin monotherapy in T2DM patients with COVID-19, as evidenced by the mitigation of oxidative stress, CT scan score, and clinical outcomes. The present study confirmed the protective effects of this combination against the development of COVID-19 severity, as most T2DM COVID-19 patients develop mild-moderate forms. Herein, the combination of metformin and sitagliptin may lead to more beneficial effects than metformin monotherapy.
Keyphrases
- sars cov
- coronavirus disease
- end stage renal disease
- newly diagnosed
- ejection fraction
- oxidative stress
- prognostic factors
- peritoneal dialysis
- stem cells
- type diabetes
- coronary artery disease
- metabolic syndrome
- patient reported outcomes
- adipose tissue
- insulin resistance
- open label
- positron emission tomography
- body composition
- cardiovascular events
- gestational age
- cell therapy
- diabetic rats
- smoking cessation
- heat shock protein
- image quality