Obesity and type 2 diabetes are among the most important risk factors for severe coronavirus disease-19. Some studies have suggested that the use of insulin as a therapeutic agent to treat hyperglycemia and the metabolic abnormalities associated with type 2 diabetes during the acute phase of severe coronavirus disease-19 could have a negative impact on the disease’s progression; however, there is no consensus on this issue. Here, we performed a systematic review in an attempt to answer this important question. We included 29 articles published from December 2019 to August 2023, which reported the outcomes of 3,070,657 patients with severe coronavirus disease-19 that had the diagnosis of diabetes and were treated with either insulin or other glucose-reducing agents. The results show that using insulin as a pharmacological intervention to treat type 2 diabetes in patients with severe coronavirus disease-19 increases the likelihood of mortality by 193%.
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