Division of Diabetes, Nutrition and Metabolic Disorders, CHU Liège, and Division of Clinical Pharmacology, Centre for Interdisciplinary Research on Medicines (CIRM), Liège University, Liège, Belgium.
Diabetes Metab. 2020 Nov;46(6):423-426. doi: 10.1016/j.diabet.2020.07.006. Epub 2020 Aug 1.
Type 2 diabetes mellitus (T2DM) is associated with both poorer clinical outcomes during the COVID-19 pandemic and an increased risk of death in such hospitalized patients. While the role of glucose control has been emphasized to improve the prognosis, the impact of different glucose-lowering agents remains largely unknown. Metformin remains the first-line pharmacological choice for the management of hyperglycaemia in T2DM. Because metformin exerts various effects beyond its glucose-lowering action, among which are anti-inflammatory effects, it may be speculated that this biguanide might positively influence the prognosis of patients with T2DM hospitalized for COVID-19. The present concise review summarizes the available data from observational retrospective studies that have shown a reduction in mortality in metformin users compared with non-users, and briefly discusses the potential underlying mechanisms that might perhaps explain this favourable impact. However, given the potential confounders inherently found in observational studies, caution is required before drawing any firm conclusions in the absence of randomized controlled trials.
2 型糖尿病（T2DM）与 COVID-19 大流行期间更差的临床结局以及此类住院患者的死亡风险增加有关。虽然强调了控制血糖以改善预后的作用，但不同的降糖药物的影响在很大程度上仍不清楚。二甲双胍仍然是 T2DM 高血糖管理的一线药物选择。因为二甲双胍除了降低血糖作用外，还具有抗炎作用，因此可以推测这种双胍类药物可能会对因 COVID-19 住院的 T2DM 患者的预后产生积极影响。本简明综述总结了来自观察性回顾性研究的现有数据，这些研究表明与非使用者相比，二甲双胍使用者的死亡率降低，并简要讨论了可能解释这种有利影响的潜在潜在机制。然而，鉴于观察性研究中固有的潜在混杂因素，在没有随机对照试验的情况下，需要谨慎得出任何确定的结论。
