April 4, 2020 : Issue #1036

TOP STORIES — Diabetes News and Research

Possible Diabetes Cure Coming Closer

40% of American Patients with Diabetes Report Financial Hardship

Which Fat Is Best in Predicting Diabetes?

A Message from the Editors: Diabetes and COVID-19

Most everyone’s attention is focused on the corona virus, the shelter at home orders, and the big drag on the economy. But insulin using patients still need to address their medication needs, and the ability to pay will only get worse before it gets better.

This week our intern Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy has put together an article pointing to those hardships. I think after you read this you may realize why educating many of your patients on the use of the $25 vials R and NPH from Walmart will likely improve their care. .

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We can make a difference!

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Dave Joffe

Editor-in-chief

The American Diabetes Association is pulling resources relevant to diabetes and COVID-19 for professionals treating patients with diabetes. This page will be updated to include links to timely webinars, panel discussions, new research, links to patient and discrimination resources, and Q&As from the COVID-19 and Diabetes Discussion Forum. Learn more at professional.diabetes.org/COVID. 

We’ve all heard by now that people with diabetes are at greater risk of serious complications from the novel coronavirus COVID-19. Research into the connection and how to best treat patients with diabetes and COVID-19 is underway, and we will be sharing the studies with you as they become available. But there are some basic reasons people with diabetes may be at higher risk. Diabetes is immunosuppressive and diabetes patients can be at increased risk from many infectious diseases. Many people with diabetes have complications like heart disease that can make it more difficult to recover from illness. The risk for type 2 diabetes increases with age, and COVID-19 is more dangerous to people over 60. 

Aside from taking standard precautions to minimize exposure to the virus, the best thing your patients can do to manage their risk of COVID-19 is to continue to practice good diabetes management. Poorly controlled blood glucose contributes to immunosuppression and can increase risk.  Patients should ensure they keep up their supply of needed medications and insulin; at this time when many people are experiencing financial hardship (especially people with diabetes) this may be a challenge for some of your patients. The ADA has a site that provides contact information for Lilly Diabetes Solution Center, Novo Nordisk NovoCare®, and Sanofi Patient Assistance Program, as well as other guidance and advice for patients who may be struggling to afford insulin, at https://insulinhelp.org/ 

Exercise is important for both physical and mental health; our exercise expert, Dr. Sheri Colberg, shares many exercises that can be done at home to help maintain core strength and flexibility, and help people cope with stress; stay tuned for another feature from her on April 11. 

Research into many drugs that may have some potential for treating COVID-19, including metformin, is underway. As yet, it is preliminary and we all know there are no miracle cures, but there will be new insight into how this virus works and what treatments are effective. There is a great deal of misinformation and rumor circulating online. DIC will always strive to be among your trusted sources for factual information in these challenging times. 

–Steve and Dave

Researchers successfully converted human cells to produce insulin, which reduced the blood sugar of mice dramatically after being infused. 

Even patients with diabetes who have insurance are experiencing more financial hardship than those without diabetes.   

The possibility of visceral fat predicting hyperglycemia. 

See the latest updates:

Jan. 30, 2021: Metformin Reduces COVID-19 Death: Diabetes is associated with an increased risk of contracting COVID-19 and increased risk of death. For those on metformin before a diagnosis of COVID-19, it is associated with reduced odds of related mortality, according to a study published online Jan. 13 in Frontiers in Endocrinology.

July 2020: New Study Finds Metformin May Lower Mortality Risk for COVID-19 

April 4, 2020: Metformin, along with dozens of drugs, may have promise against COVID-19:

Two new studies suggest that dozens of drugs already approved for use in the United States, including the diabetes drug metformin, may prove effective against the coronavirus, COVID-19. Repurposing these FDA-approved drugs could be a fast way to get treatment to patients. 

 Today, “there is no specific medicine recommended to prevent or treat the new coronavirus,” according to the World Health Organization (WHO). “Some specific treatments are under investigation and will be tested through clinical trials,” the WHO said, according to the Washington Post. 

As COVID-19 sickens hundreds of thousands, the race is on to find a drug that might help save severely ill patients.  But even with rapid government approval, it could take months to develop new drugs from scratch that might be effective against the virus. 

The World Health Organization is conducting computer modeling studies on certain drugs already approved by the FDA. The results showed that the most promising drugs included several antiviral drugs, including darunavir, nelfinavir, and saquinavir – and several other types of drugs, including the ACE inhibitor moexipril; the chemotherapy drugs daunorubicin and mitoxantrone; the painkiller metamizole; the antihistamine bepotastine; and the antimalarial drug atovaquone.  Another promising candidate is the cholesterol-lowering statin rosuvastatin.   

  A second study was done at the University of California, San Francisco. It found that nearly 70 drugs, some already approved, might prove effective against the novel coronavirus.  They just published their findings on the web site bioRxiv.  In this effort, the researchers took a deep dive into the genetic makeup of the novel coronavirus, focusing on critical proteins the virus uses to hijack the genetic machinery of a human host cell. The coronavirus uses the cell’s protein to manufacture millions of copies of itself.  The researchers looked at drugs that target the same human cellular proteins that the virus also targets during its invasion of the host cell. They uncovered 24 drugs already approved by the FDA for use against a range of diseases, such as cancer, Parkinson’s disease and high blood pressure.  Also on the list were certain antibiotics, metformin, the go-to drug for type 2 diabetes; the schizophrenia drug haloperidol; and the malaria drug chloroquine. Trials are being planned by the WHO and the state of New York. 

https://www.drugs.com/news/many-already-approved-fda-may-have-promise-against-covid-19-89140.html

Update: July 4, 2020: New Study Finds Metformin May Lower Mortality Risk for COVID-19

Studies have shown that type 2 diabetes (T2DM) and obesity are significant risks for mortality in COVID-19. Now, according to a new study published by MedRxiv, women who were taking metformin had a 21% to 24% lower risk of dying from COVID-19, compared to men and those who didn’t take the drug, based on data from 6,200 hospitalized COVID-19 patients. The study also found that metformin lowered C-reactive protein levels twice as much in women as in men. Metformin has sex specific immunomodulatory effects which may elucidate treatment mechanisms in COVID-19.

“We know that metformin has different effects on men and women,” study coauthor Carolyn Bramante of the University of Minnesota said, adding that “In the diabetes prevention trial, metformin reduced CRP (the inflammation marker C-reactive protein) twice as much in women as men.”  Metformin also decreases levels of TNF-alpha, an inflammation protein that appears to make COVID-19 worse, she said. “The fact that we saw the benefit in women only, and the fact that metformin lowers TNF-alpha in female mice, might suggest that the TNF-alpha effects of metformin are why it helps in COVID-19.”

This small study has not yet been peer-reviewed. MedRxiv

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:

Deonna Andrews, PharmD Candidate 2020 of Florida Agricultural & Mechanical University College of Pharmacy and Pharmaceutical Sciences  

Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy 

Chardae Whitner PharmD Candidate L|E|C|O|M Bradenton School of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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