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0 0.5 1 1.5 2+ Mortality 45% Improvement Relative Risk Hospitalization time 7% Metformin  Chertok Shacham et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 359 patients in Israel (April 2020 - March 2021) Study compares with insulin, results vs. placebo may differ Lower mortality with metformin (p=0.00014) Chertok Shacham et al., Medicine, January 2023 Favors metformin Favors insulin

Blood glucose control with different treatment regimens in type 2 diabetes patients hospitalized with COVID-19 infection: A retrospective study

Chertok Shacham et al., Medicine, doi:10.1097/md.0000000000032650
Jan 2023  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 87 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 359 COVID-19 patients with diabetes in Israel, showing lower mortality in the other treatments group compared to the insulin group, with 80% of the other treatments group receiving metformin. Groups refer to use during hospitalization, however most are likely continuation of existing diabetes treatment.
risk of death, 44.9% lower, RR 0.55, p < 0.001, treatment 39 of 162 (24.1%), control 86 of 197 (43.7%), NNT 5.1, 80% of treatment patients received metformin.
hospitalization time, 6.7% lower, relative time 0.93, p = 0.50, treatment 162, control 197, 80% of treatment patients received metformin.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chertok Shacham et al., 20 Jan 2023, retrospective, Israel, peer-reviewed, 3 authors, study period 1 April, 2020 - 31 March, 2021, this trial compares with another treatment - results may be better when compared to placebo.
This PaperMetforminAll
Blood glucose control with different treatment regimens in type 2 diabetes patients hospitalized with COVID-19 infection: A retrospective study
Elena Chertok Shacham, BS b , Nimra Maman, MD Avraham Ishay
Medicine, doi:10.1097/md.0000000000032650
Coronavirus disease (COVID-19) is closely associated with hyperglycemia and a worse prognosis in patients with a previous diagnosis of type 2 diabetes mellitus. A few studies investigated the effects of diabetes treatment regimens in these patients during hospitalization. Here, we evaluate the impact of insulin and non-insulin therapy on glucose control in patients with type 2 diabetes admitted with COVID-19. This is a retrospective study including 359 COVID-19 patients with type 2 diabetes. Patients were divided into 2 groups according to diabetes treatment during hospitalization. The first group included patients treated with insulin only, and the second group patients treated with other antidiabetic agents with or without insulin. Average blood glucose was higher in the insulin-only treatment group (201 ± 66 mg/dL vs 180 ± 71 mg/dL, P = .004), even after excluding mechanically ventilated patients (192 ± 69 vs 169 ± 59 mg/dL, P = .003). In patients with moderate severity of COVID-19, average blood glucose was also significantly higher in the insulin-only treated group (197 ± 76 vs 168 ± 51 mg/dL, P = .001). Most patients (80%) in the combination treatment group received metformin. Moderately affected COVID-19 patients with type 2 diabetes could safely be treated with antihyperglycemic medications with or without insulin.
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