Effective Response to DPP-4 Inhibitors in Patients of COVID – 19 Triggered Uncontrolled Type 2 DM – A Case Report
Akshay Dahiwele *
Department of Pharmacology, Jawaharlal Nehru Medical College, Sawangi, Wardha, India.
Shailesh Patil
Department of Cardiovascular & Respiratory Physiotherapy, Datta Meghe College of Physiotherapy, Nagpur, India.
Sarju Zilate
Department of Pharmacology, Jawaharlal Nehru Medical College, Sawangi, Wardha, India.
Harsh Salankar
Department of Pharmacology, Jawaharlal Nehru Medical College, Sawangi, Wardha, India.
Sonali Rode
Department of Pharmacology, Jawaharlal Nehru Medical College, Sawangi, Wardha, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: A bidirectional relationship exist between the COVID -19 diagnosed & recovered patient and Type 2 Diabetes Mellitus. As per the various article available in public domain it has been proved that entry of COVID – 19 virus can lead to a series of pathological changes into a patient’s body which may lead to the development of insulin resistance and damage to the pancreas.
The patient in our case was a COVID – 19 survivor which was diagnosed with type 2 DM during the treatment. The patient was started with the Glargine insulin when she was undergoing her treatment in the hospital for COVID – 19 Symptoms. Her fasting and postprandial blood sugar level was controlled with the insulin. After her discharged she was started with the Metformin 500 mg twice a day but her blood sugar was not controlled with the Metformin monotherapy, so we started with the triple drug combination Metformin + Glimepiride + Pioglitazone. After 1 month of follow-up, it was seen that the blood sugar level was not controlled, so the Pioglitazone was replaced with the DPP-4 inhibitor drug Vildagliptin and again the patient was asked to come for follow-up after 15 days, it was seen in this follow-up that the patients’ blood sugar was dramatically controlled.
Conclusion: COVID – 19 triggered Type 2 DM is the result of cytokine storm develop during the disease. Metformin and DPP – 4 inhibitors reduce the insulin resistance in type 2 diabetes patients and helps to achieve the euglycemic goal of the patient.
Keywords: DPP - 4 inhibitors, Uncontrolled diabetes, COVID - 19, Vildagliptin, Triggered Type 2 DM