Abstract

Abstract Background We aimed to evaluate the mortality of eight glucose-lowering therapies for COVID-19 patients with diabetes prior to diagnosis of COVID-19. Methods We searched PubMed, Embase, Cochrane Central Register, Web of Science, and ClinicalTrials.gov through June 2021. COVID-19 patients with diabetes while receiving glucose-lowering therapies for at least 14 days prior to COVID-19 confirmed were included. The Newcastle Ottawa scale (NOS) was used to assess the risk of bias in nonrandomized studies. Bayesian network meta-analyses were performed. Results Eleven distinct observational studies (3,631,682 COVID-19 patients with diabetes mellitus) were included. Compared with insulin, DPP4i, secretagogues, glucosidase inhibitors, and thiazolidinediones, the incidence of adverse outcomes in diabetics who took SGLT2i was relatively lower: OR 0.30 (95% CrI 0.17-0.55); 0.42 (0.24-0.83); 0.43 (0.24-0.83); 0.32 (0.16-0.70); 0.47 (0.23-0.95). The SUCRA value of SGLT2i was the lowest (1.8%), followed by GLPIRA (22.1%) and biguanides (33.3%). Conclusion SGLT2I may be an optimal choice for diabetics before COVID-19 infection. GLP1RA and guanidine can also be a good choice for the protection of diabetics during COVID-19 pandemic times. Presentation: No date and time listed

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