Open AccessJudicious use of sodium-glucose cotransporter 2 inhibitors in patients with diabetes on coronavirus-19 pandemic
Author(s) -
Chun-Fan Chen,
Yung Tai Chen,
Tz Heng Chen,
Fan Yu Chen,
Yi Yang,
MongLien Wang,
Teh Ia Huo,
Yuh Lih Chang,
Ann Charis Tan,
Chih Ching Lin
Publication year - 2020
Publication title -
journal of the chinese medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.535
H-Index - 42
eISSN - 1728-7731
pISSN - 1726-4901
DOI - 10.1097/jcma.0000000000000354
Subject(s) - medicine , diabetes mellitus , pandemic , covid-19 , coronavirus , renal sodium reabsorption , kidney , cotransporter , endocrinology , disease , reabsorption , sodium , infectious disease (medical specialty) , chemistry , organic chemistry
Sodium glucose cotransporter-2 inhibitors (SGLT2i), a novel antidiabetic drug blocks the reabsorption of glucose in proximal tubules of kidney, are demonstrated to have cardiovascular and renal benefits for people with diabetes. The benefits are associated with the significant increase of intrarenal angiotensin-converting enzyme II (ACE2) expression and blood volume contraction. However, the increased ACE2 may be detrimental to patients infected with the coronavirus infection 2019 (COVID-19), which is found to invade cells via the entry receptor of ACE2. Besides, an SGLT2i-induced natriuretic effect may also increase the risk of acute kidney injury and affect the hemodynamic stability during systemic infection disease. In this article, we explain the mechanisms why the use of SGLT2i in people with diabetes may lead to worse outcomes and suggest clinician to judiciously use it during COVID-19 pandemic.