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. 2021 Oct 15;12(10):1674–1692. doi: 10.4239/wjd.v12.i10.1674

Table 1.

Use of antidiabetic medications in patients with type 2 diabetes and coronavirus disease 2019


Insulin
Sulfonylurea
Metformin
DPP-4 inhibitors
SGLT-2is
GLP-1a
Benefits Guarantee of achieving glycemic control; Cardiovascular neutrality; Possible use in multivisceral failure Cardiovascular neutrality (demonstrated only with Glimepiride) Probable cardiovascular benefit; No risk of hypoglycemia improvement of inflammation and endothelial dysfunction Cardiovascular neutrality; Possible use in severe renal impairment and hypoxia; Possible inhibitory role on the entry of the virus into the cell; No risk of hypoglycemia Proved cardiovascular and renal protective benefits; No risk of hypoglycemia Improvement of inflammation Proved cardiovascular and renal protective benefits; Possibility of use up to the stage of severe renal failure; No risk of hypoglycemia; Improvement of inflammation and endothelial dysfunction
Risks Increased glycaemic variability hypoglycaemic risks Hypoglycaemic risk, contraindication in case of severe liver and renal failure Multiple contraindications (hypoxia, severe renal failure, severe heart failure, severe liver failure); Risk of lactic acidosis especially in severe renal failure Possible dysregulation of T cell function and T cell mediated inflammatory and immune responses Reduced efficacy in moderate to severe renal impairment; Risk of ketoacidosis, especially in severe sepsis Risk of dehydration Risk of digestive side effects; Risk of worsening undernutrition
Association with severe form of COVID-19 in observational studies Conflicting results Lower risk of severe form of COVID-19 or neutral association Lower risk of severe form of COVID-19 or neutral association Conflicting results Lower risk of severe form of COVID-19 or neutral association Neutral association
Medication use and severity of COVID-19 infection Possibility of use at all stages of the disease and particularly in severe forms, especially recommended if blood sugar level is over 10-11 mM Possible use up to moderate forms in the absence of severe renal and liver failure Recommended use up to moderate forms in the absence of contraindications Possible use up to moderate forms Possible use up to moderate forms in the absence of moderate to severe renal failure Possible use up to moderate forms

COVID-19: Coronavirus disease 2019; DPP-4: Dipepetidyl peptidase-4; SGLT-2is: Sodium-glucose cotransporter-2 inhibitors; GLP-1a: Glucagon like peptide-1 analogues.