Takeaway
Type 2 diabetes (T2D) patients prescribed metformin, sodium-glucose cotransporter-2 inhibitors (SGLT2i) and sulfonylureas were at a lower risk of COVID-19-related mortality than those not prescribed these drugs.
The risk was higher in those prescribed insulin and dipeptidyl peptidase-4 inhibitors (DPP-4i).
The differences in risk were small and were likely to be because of confounding rather than direct drug effects.
Why this matters
Findings suggest that there is no evidence to change prescribing of glucose-lowering drugs in people with T2D in the context of COVID-19 pandemic.
Study details
A nationwide observational cohort study of 2,851,465 people diagnosed with diabetes who were included in the 2018-2019 National Diabetes Audit dataset and registered with a general practice in England since 2003.
Funding: None.
Key results
During 1,517,762 person-years of follow-up, 13,479 (0.5%) COVID-19 deaths occurred, corresponding to a crude mortality rate of 8.9 per 1000 person years (95% CI, 8.7-9.0).
Adjusted HRs (95% CI) for COVID-19 mortality in patients with prescription of glucose-lowering drug vs no prescription of the drug were:
metformin: 0.77 (0.73-0.81);
meglinitides: 0.75 (0.48-1.17);
SGLT2i: 0.82 (0.74-0.91);
thiazolidinediones: 0.94 (0.82-1.07);
sulfonylureas: 0.94 (0.89-0.99);
GLP-1RA: 0.94 (0.83-1.07);
DPP-4i: 1.07 (1.01-1.13);
α-glucosidase inhibitors: 1.26 (0.76-2.09); and
insulin: 1.42 (1.35-1.49).
Limitations
Data on medication adherence and treatment dose were lacking.
Risk of residual confounding.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Glucose-lowering Drugs and Risk of COVID-19 Mortality in People with T2D - Medscape - Apr 02, 2021.
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