Study: Glucose-Lowering Drugs Have Neutral Impact on COVID-19 Mortality

Despite a neutral effect from glucose-lowering drugs on coronavirus disease 2019 (COVID-19) mortality, investigators noted a close relationship between diabetes and COVID-19, saying it calls for more research.¹

According to the investigators, there is limited evidence on the role of glucose-lowering drugs in patients with COVID-19, whether alone or in combination with metformin. To investigate, researchers selected all patients with type 2 diabetes in the Spanish Society of Internal Medicine’s SEMI-COVID-19 Registry, which is a nationwide registry of patients admitted for COVID-19 in Spain beginning on March 1, 2020. Each patient prescribed a glucose-lowering drug was matched with a user of other glucose-lowering drugs based on propensity scores.¹

Among the 2666 patients identified, 1297 were on glucose-lowering drugs in monotherapy and 465 were in combination with metformin. After propensity matching, investigators selected 249 patients on metformin; 105 on dipeptidyl peptidase-4 inhibitors; 34 on metformin and a sodium-glucose cotransporter 2 inhibitor; and 67 on metformin and insulin.¹ According to the findings, no at-home glucose-lowering drugs showed a significant association with in-hospital death, complications, or long-term hospital stays.¹

Based on these findings, the authors said at-home glucose-lowering drugs had a neutral effect on mortality and adverse outcomes in patients with type 2 diabetes admitted for COVID-19. However, they added that more prospective studies are necessary because of the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs.¹

In peer reviews of the study, researchers noted that the authors did not specify drugs used during hospital stays, making their conclusions difficult to generalize; however, reviewers agreed that further research is important.²

“There is a paucity of evidence concerning the impact of glucose-lowering drugs and their effect on those infected with COVID-19; thus this study is relevant and brings insight to this ever-growing topic,” said Tamaryn Fox, MD, in a peer review.²

Susanna Hofmann, MD, division head at Helmholtz Diabetes Center, said the study may be useful to point of care providers when determining treatment strategies for patients admitted to the hospital.²

“Importantly, the authors report here valuable information how glucose-lowering drugs taken by [type 2 diabetes] patients at home affect hospital stay outcomes,” Hofmann said in the review. “This knowledge may come in very handy at hospital admission and for the treatment strategy during the hospital stay of these patients.”²

REFERENCE

• Perez-Belmonte L, Torres-Pena J, Lopez-Carmona M. Impact of Glucose-Lowering Drugs on Mortality and Other Adverse Outcomes in Patients with Type 2 Diabetes Admitted for COVID-19. The Lancet; September 3, 2020. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3666251. Accessed November 2, 2020.
• Can glucose-lowering drugs impact mortality in COVID-19 patients with type 2 diabetes? [news release]. EurekAlert; October 30, 2020. https://www.eurekalert.org/pub_releases/2020-10/tmp-cgd103020.php. Accessed November 2, 2020.