Benefits of sitagliptin in COVID-19 for diabetic patients – BioAge
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Benefits of sitagliptin in COVID-19 for diabetic patients

Sitagliptin is a bio pellet used to treat type 2 diabetes. Type 2 diabetes is a condition in which the body does not produce enough insulin or the insulin it produces does not work properly. This can cause high blood sugar levels (hyperglycemia). Treatment is often combined with metformin bio-pellet. Managing your diabetes properly can also reduce your risk of heart attack or stroke. Sitagliptin works by increasing levels of naturally occurring substances called incretins. Incretins help control blood sugar levels by increasing the release of insulin, especially after a meal.
Results from a retrospective case-control study show that sitagliptin, a dipeptidyl peptidase (DPP) -4 inhibitor, may improve outcomes in people with type 2 diabetes hospitalized with COVID-19.
Risks to mechanical ventilation admissions to intensive care and mortality decreased by half or more, according to the results published in Diabetes Care.
The study was conducted in Italy, where it is standard practice for hospitalized patients with type 2 diabetes to stop all medications and control blood glucose with intravenous or subcutaneous insulin.
But in light of emerging data during the pandemic, some diabetes patients hospitalized with COVID-19 were also given supplemental sitagliptin. Paolo Fiorina (University of Milan, Italy) and co-authors identified 169 such patients and matched them by age and sex with 169 who received only insulin.
The two groups had similar baseline characteristics, with the only significant difference in beta-blocker use: 33% versus 56% in the sitagliptin and standard therapy groups; respiratory rate on average 23.7 versus 25.8 breaths / min; and C-reactive protein level 14 versus 19 mg / L.
30 days after hospitalization, 8% of patients receiving sitagliptin died compared with 37% of patients receiving standard treatment, which in multivariate analysis corresponded to a significant reduction in risk 77%.
Similarly, 6 versus 17 patients required mechanical ventilation (73% risk reduction), and 15 versus 25 patients required intensive care unit hospitalization (49% risk reduction). {{1 }} Mean blood glucose levels were significantly lower in sitagliptin-treated patients compared to standard treatment during hospitalization, in line with previous studies linking hyperglycemia during hospitalization with poor COVID-19 outcomes.
And Assessed over a 30-day follow-up period, patients treated with sitagliptin also had significantly lower levels of inflammatory markers such as procalcitonin and C-reactive protein. The researchers note that “modulation of DPP-4 expression on immune cells by sitagliptin may induce broad anti-inflammatory and immunoregulatory effects.
The key rationale for the use of the DPP-4 inhibitor (sitagliptin) in COVID-19 patients is new evidence. that “DPP-4 can facilitate the entry of SARS-CoV-2 into cells. Thus, the use of DPP-4 inhibitors can reduce the virulence of SARS-CoV-2, thereby preventing subsequent multiple organ failure and acute and chronic lung damage, as well as preventing the cytokine storm caused by lung damage.
Researchers are currently training recruit patients for a randomized controlled trial (NCT04365517) to confirm the sitagliptin benefits found in this retrospective study, and they suggest it might also be beneficial to test the drug in COVID-19 patients without diabetes.

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