The COVID-19 Pandemic is taking a toll on people with diabetes.

Although people with diabetes are not more likely than the general population to be infected by COVID-19, they have much higher mortality rates than people without diabetes once infected with the virus.

Hopeful news. A recent study demonstrated that starting sitagliptin (Januvia) on hospital admission dramatically decreases mortality and improves outcomes for those with diabetes and COVID-19.

The Corona Virus appears to have two portals of entry in humans.

• Corona Virus can enter through the ACE2 receptors that are located throughout the body.
• Coronavirus also appears to bind to DPP-4 cells in the respiratory tract.

In a recent study released in September in Diabetes Care, “Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study by Solerte et al”, the researchers demonstrated reduced mortality, improved clinical outcomes, and a greater number of hospital discharges for those started on sitagliptin on admission.

The COVID-19 virus seems to bind to the DPP-IV enzyme and the enzymatic activity of DPP4 causes overexpression of inflammatory cytokines, exaggerating the inflammatory response.

Since sitagliptin is a DPP-IV inhibitor, the researchers believe that the medication inhibited the virus’s ability to bind to DPP-IV. This had a net effect of decreasing the intense inflammatory response, often termed the “cytokine storm” associated with COVID-19 infections.

Treatment with sitagliptin on admission dramatically improved outcomes.

This Multicenter, Case-Control, Retrospective, Observational Study followed 338 consecutive patients with type 2 diabetes and COVID-19 admitted to Northern Italy hospitals.

Included in this study were 169 patients on sitagliptin and 169 on the standards of care. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support.

RESULTS: Treatment with sitagliptin at the time of hospitalization was associated with:

• Reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P 5 0.0001) }
• Improvement in clinical outcomes (60% vs. 38% of improved patients; P 5 0.0001) }
• Greater number of hospital discharges (120 vs. 89 of discharged patients; P 5 0.0008) compared with patients receiving standard of care, respectively.

Sitagliptin contributed to a lowered risk and progression of acute respiratory complications for people with type 2 diabetes and COVID-19.

This research suggests that DPP-4 inhibitors can help decrease COVID-19-related immune overreaction in people with diabetes and dramatically improve outcomes.

Read article here >> Sitagliptin Treatment at the Time of Hospitalization was Associated with Reduced Mortality in Patients with Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study, Solerte et al. Diabetes Care 2020, Sept

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Want to learn more about the most recent finding in Diabetes and COVID-19?

COVID & Diabetes Update
Navigating a Crisis

Recorded & Ready for Viewing

Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, has completely updated this critical presentation, to bring health care professionals up-to-date on the current state of COVID and its impact on diabetes care. She summarizes key information including critical teaching points and management strategies for people with diabetes who develop a COVID-19 infection.

Topics Include:

1. Discuss the current state of diabetes in the United States.
2. Describe the relationship between COVID and health care disparities 
3. Explore the impact of COVID infection on those with pre-existing diabetes.
4. Discuss treatment strategies for COVID and diabetes, including new vaccines.
5. List critical teaching points for people with diabetes and COVID.

Join us to learn critical information about Diabetes and COVID Management

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF and Touro University and a nationally recognized diabetes expert.

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