Metformin and AGIs show potential for improved outcomes in COVID-19 patients with type 2 diabetes

A team of researchers led by Dr. Dao Wen Wang at Huazhong University of Science and Technology has conducted a comprehensive retrospective study analyzing the effects of different diabetes medications on COVID-19 outcomes. This study, involving data from 4,922 patients with COVID-19 and T2DM across 138 hospitals in Hubei Province, China, sheds light on the potential benefits of metformin and alpha-glucosidase inhibitors (AGIs) while raising concerns about insulin use.

The research is published in the journal Molecular Biomedicine.

The study, conducted between December 2019 and August 2021, found a significant association between metformin and AGI use and reduced all-cause mortality in COVID-19 patients with T2DM. Conversely, insulin use was linked to an increased risk of death. These findings were consistent even after adjusting for age, sex, comorbidities, and other medications.

The researchers utilized various statistical methods, including multivariate Cox regression and propensity score matching, to ensure the robustness of their findings. Subgroup analyses further confirmed the observed associations in different patient populations, including critically ill patients and those with poorly controlled blood glucose levels.

This research challenges previous recommendations prioritizing insulin for managing hyperglycemia in COVID-19 patients with T2DM. While the study is retrospective and cannot establish causality, the findings underscore the need for further research and careful consideration when prescribing insulin for this vulnerable population.

Dr. Wang emphasizes, "Our study suggests that metformin and AGIs may be more suitable treatment options for COVID-19 patients with T2DM. Clinicians should exercise caution when considering insulin therapy for these individuals."