The Phenomenon of Metformin in COVID-19 Pandemic Among Polish Patients with Type 2 Diabetes Mellitus

OBJECTIVE: The aim was to compare the metabolic control of patients with type 2 diabetes mellitus (DM2) before and during the COVID-19 pandemic in Poland and assess its impact on cardiovascular risk. METHODS: Patients with DM2, treated with metformin and/or insulin were analysed with Pearson and ANOVA correlations. Blood levels of metabolic control biomarkers were checked throughout the first pandemic wave were compared to the results obtained before the 4th of March, 2020 (1st confirmed case in Poland). RESULTS: 598 patients cases with mean weight 87.07 kg (±19.54) were analysed. 22.41% (n=134) were treated solely with insulin, 42.64% (n=255) with metformin and 28.6% (n=171) were prescribed a combination of those. The baseline HbA1c and creatinine levels were at 7.33% (±1.39) and 1.16mg/dl (±0.76) respectively and rose by 0,19% (p=0.02) and 0.07mg/dl (p=0.004). The patient attendance for blood testing decreased by 42.18% in comparison to the pre-pandemic period. All patients have shown a rise in creatinine levels, but those treated only with metformin rose by 0,01mg/dl, which was a significantly smaller increase. CONCLUSIONS: The increase in levels of creatinine and HbA1c, which may have an impact on cardiovascular risk, suggests that lockdown and its consequences resulted in a deterioration of metabolic control. Stronger support of patients and preparations for upcoming pandemic waves are necessary to avoid further complications in patients with DM2. The improvement of renal parameters in the group of patients treated only with metformin confirms its nephroprotective effect and it still should be used as first-line treatment..