Effective Response to DPP-4 Inhibitors in Patients of COVID – 19 Triggered Uncontrolled Type 2 DM – A Case Report

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.