A class of prescription medicines used in conjunction with diet and exercise to manage type 2 diabetes could also help treat people with COVID-19, according to a researcher in America.

Dr Gianluca Iacobellis, a medicine professor and endocrinologist at the University of Miami Miller School of Medicine, has written an article about how he thinks DDP4 inhibitors such as sitagliptin, saxagliptin, linagliptin, and alogliptin might hold the key to targeting the global pandemic.

He has studied previous coronavirus research and said there is evidence to suggest that the DPP4 enzyme is interacting with COVID-19, which indicates it might have a significant role to play in battling the killer virus.

DPP4 is found throughout the body and it plays an important role in inflammatory responses and insulin regulation. DPP4 inhibitors are used to help increase insulin and GLP-1 secretion among those with type 2 diabetes

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Dr Iacobellis said: “The body is overreacting with this inflammatory response to the virus. This could be partially mediated by DPP4. The virus binds to the enzyme and the enzymatic activity of DPP4 overexpresses inflammatory cytokines, exaggerating the inflammatory response

“Previous studies, of SARS and MERS, showed that, if you blocked DPP4 activity, there was a reduction in the inflammatory response. This could ameliorate the immune response to the virus.”

Previous research carried out in Wuhan – where the COVID-19 crisis began – and in Italy has indicated that mortality and intensive care unit admission rates are significantly higher among people who have type 2 diabetes.

The government has been advising people with diabetes to be “particularly stringent” in following social distancing measures.

Those with either type 1 or type 2 diabetes have been included on a list which outlines who may be at an increased of infection. 

Dr. Iacobellis said more research is needed before clinicians can start turning to DPP4 inhibitors to help treat people with COVID-19, but he thinks early indications look positive. 

He said: “Starting with diabetes patients, we should be conducting randomised studies to test whether treating those with mild or moderate symptoms improves outcomes. These drugs are well tolerated and may provide therapeutic benefit.”

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