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Exp Clin Endocrinol Diabetes 2023; 131(05): 260-267
DOI: 10.1055/a-2019-1111
Review

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

Djordje S. Popovic   *
1   Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Novi Sad, Serbia
2   Medical Faculty, University of Novi Sad, Novi Sad, Serbia
,
Nikolaos Papanas   *
3   Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
,
Theocharis Koufakis   *
4   Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
,
Kalliopi Kotsa   *
4   Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
,
Wael Al Mahmeed
5   Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
,
Khalid Al-Rasadi
6   Medical Research Center, Sultan Qaboos University, Muscat, Oman
,
Kamila Al-Alawi
7   Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat, Oman
,
Maciej Banach
8   Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland
9   Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
10   Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
,
Yajnavalka Banerjee
11   Department of Biochemistry, Mohammed Bin Rashid University, Dubai, United Arab Emirates
,
Antonio Ceriello
12   IRCCS MultiMedica, Milan, Italy
,
Mustafa Cesur
13   Clinic of Endocrinology, Ankara Güven Hospital, Ankara, Turkey
,
Francesco Cosentino
14   Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, Sweden
,
Alberto Firenze
15   Unit of Research and International Cooperation, University Hospital of Palermo, Italy
,
Massimo Galia
16   Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, Italy
,
Su-Yen Goh
17   Department of Endocrinology, Singapore General Hospital, Singapore
,
Andrej Janez
18   Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Slovenia
,
Sanjay Kalra
19   Department of Endocrinology, Bharti Hospital, Karnal, India
,
Peter Kempler
20   Department of Medicine and Oncology, Semmelweis University, Budapest, Hungary
,
Nitin Kapoor
21   Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
22   Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
,
Nader Lessan
23   The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
,
Paulo Lotufo
24   Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
,
Ali A. Rizvi
25   Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA
,
Amirhossein Sahebkar
26   Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
27   Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
28   Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
,
Raul D. Santos
29   Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
30   Hospital Israelita Albert Einstein, Sao Paulo, Brazil
,
Anca Pantea Stoian
31   Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, Bucharest, Romania
,
Peter P. Toth
32   Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Vijay Viswanathan
33   Diabetes Research Centre, Chennai, India
,
Manfredi Rizzo   *
11   Department of Biochemistry, Mohammed Bin Rashid University, Dubai, United Arab Emirates
31   Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, Bucharest, Romania
34   Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), School of Medicine, University of Palermo, Italy
› Author Affiliations Funding No funding or sponsorship was received for the preparation or publication of this article.
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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.

Key words

coronavirus disease 2019 - dipeptidyl peptidase 4 inhibitor - glucagon-like peptide-1 receptor agonist - sodium-glucose co-transporter-2 inhibitor - type 2 diabetes mellitus

* These authors have contributed equally to the present work.




Publication History

Received: 23 August 2022
Received: 13 November 2022

Accepted: 24 January 2023

Accepted Manuscript online:
24 January 2023

Article published online:
08 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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