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.
