Anna Huckabee, Rachel Parise, Jack Deruiter, Jun Ren, Manoj Govindarajulu, Sindhu Ramesh, Rishi M. Nadar, Timothy Moore, Muralikrishnan Dhanasekaran

The aim of this meta-analysis was to elucidate the beneficial/iatrogenic impact of COVID-19 therapy (drugs and biologicals) on patients with diabetes mellitus. The hypothesis of the current study is that COVID-19 treatment improves hyperglycemia through the abolition of the COVID-19 infection. A literature search with key terms, such as “COVID-19 therapy and diabetes mellitus” was conducted using PubMed through September 2021. The CDC data were referenced for the current COVID-19 profile and statistics. The NIH COVID-19 guidelines were referenced for updated treatment recommendations. Micromedex and UpToDate were used for drug and disease information. Our results indicated that corticosteroids (dexamethasone), remdesivir, and antivirals (lopinavir, and ritonavir) all have the potential to significantly raise blood glucose levels; thus, putting patients at elevated risk for severe complications. In contrary, hydroxychloroquine is associated with hypoglycemia, and tocilizumab (IL-6 inhibitor) is associated with improving glucose levels via decreasing inflammation. Other anti-cytokine bioactive molecules, such as anakinra (anti-IL-1 receptor) and TNF-alpha inhibitors, are correlated with lower blood glucose in patients with and without diabetes mellitus. An agent used for mild COVID-19 disease, ivermectin possesses the potential for lowering blood glucose. Despite undergoing a current clinical trial, comastat mesylate is also associated with decreasing blood glucose. In terms of preventative therapy, Covishield, Pfizer BioNTech, and Moderna have all been associated with hyperglycemia after the first dose. On average, reports from diabetic patients noted higher blood sugar levels at 1-7 days post-vaccination. Therefore, individualized patient care is needed for diabetes mellitus patients with COVID-19 infection. This is important as improper drug therapy aggravates hyperglycemic conditions and other comorbid conditions, thereby leading to increased morbidity and mortality.   

Keywords: COVID-19, COVID-19 treatment, comorbidity, diabetes mellitus, hyperglycemia, blood glucose, iatrogenesis