What are the adverse effects of dipeptidyl peptidase IV inhibitors (DPP-4 inhibitors) in the treatment of type 2 diabetes mellitus (DM), and what is the benefit of sitagliptin in patients with type 2 diabetes who are hospitalized with COVID-19?

Updated: Jul 13, 2021
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Upper respiratory tract infections have been increasingly reported among users of DPP-4 inhibitors compared with users of other antidiabetic drugs. [234] However, further research is needed to evaluate the scope and underlying mechanisms of this phenomenon. On the other hand, a meta-analysis suggested that treatment with DPP-4 inhibitors could reduce the risk of bone fractures. [235]

A case-control, retrospective, observational study by Solerte et al suggested that in patients with type 2 diabetes mellitus who are hospitalized with COVID-19, glucose lowering with sitagliptin rather than treatment with insulin reduces the likelihood of 30-day death by 77%. The investigators also indicated that the rate at which intensive care or mechanical ventilation is needed in these patients is significantly reduced as well. [236, 237]

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