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| Diabetes medications lower the risk of MS in female patients under the age of 45 |
Exposure to diabetes medications lowers the risk of multiple sclerosis in female patients under the age of 45. Anti-hyperglycemic medicine usage is linked to a decreased risk of multiple sclerosis (MS) in younger persons with type 2 diabetes, but increased risk in older patients, particularly women. The research "Age and sex differences in anti-hyperglycemic drug exposure and risk of newly diagnosed multiple sclerosis in propensity score matched type 2 diabetics" published in Heliyon supports this.
The researchers concluded that "these findings represent an important call to action for improving our understanding of the interactions between the endocrine [hormonal], immune, and nervous systems and the need for a precision medicine approach for multiple sclerosis prevention in vulnerable populations."
Diabetes develops when the body struggles to control blood sugar levels.
Diabetes is a disorder in which the body struggles to control blood sugar levels. Insulin and other medications used to manage blood sugar levels in persons with type 2 diabetes are known as anti-hyperglycemic drugs or A-HgM.
A few studies have hypothesized that patients with type 2 diabetes may be more prone to acquire MS, although there is still no convincing evidence linking the two conditions. A-HgM consumption may have an impact on MS risk, thus researchers from the University of Arizona undertook an investigation to determine this.
According to the researchers, this is the broadest and most thorough study to date looking at how certain anti-hyperglycemic medications affect MS risk.
The health information of 122 million people was gathered from 2010 to 2018 and is contained in a U.S. insurance claims database called Mariner, which the researchers used to conduct their analysis.
Even while using insurance data made it possible to examine a large number of patients, the researchers acknowledged that this method of data does not offer a whole clinical picture, which is a drawback of this study.
More than 5 million persons with type 2 diabetes were found, and they were split into two groups based on when they were diagnosed: before or after the age of 45.
An examination of propensity score matching was performed. In essence, the researchers separated diabetic patients who had records of using anti-hyperglycemic drugs from those who did not, despite the fact that they had otherwise extremely comparable demographic and clinical characteristics.
The research eventually included matched individuals who were not taking the medications but were probably treating their diabetes with diet and exercise, as well as 143,613 younger diabetic patients and 638,625 older patients who were receiving A-HgM therapy. They all had Mariner records going back at least three years and six months, and they had never before experienced a neurodegenerative condition.
The researchers next assessed if there were any differences in MS risk between A-HgM and non-A-HgM groups. One year following the diabetes diagnosis, the progression of MS was evaluated either by an MS diagnosis or by the use of MS therapies that were documented in the database.
Results indicated that among individuals with diabetes diagnosed before age 45, those using A-HgM had a 78% lower risk of developing MS the following year compared to those not taking the drug. The outcomes were comparable between the sexes.
However, when taking into account the entire population, "the incidence of MS is still larger in the younger [group], which is consistent with national trends and data for MS prevalence," the authors stated.
Diabetes medication use in older adults increased the incidence of MS by 36%.
In contrast, those identified beyond the age of 45 who were taking A-HgM had a 36% increased chance of getting MS compared to those who were not. Compared to men, Women had a larger chance of developing this condition than males did (53% vs. 17% higher risk).
In addition to the fact that "diabetes, similar to MS, is associated with a proinflammatory state," the researchers concluded that this sex-related difference "may be attributed to alterations in the immune system during the transition to menopause."
However, in the older group, insulin was linked with a much greater risk of developing MS (84% increased risk) compared to other medications (24%-38% increased risk). This finding was consistent with comparisons of various A-HgM regimens that typically had comparable outcomes.
The researchers concluded that "this can be partially explained by the severity of the illness, [blood sugar] management, or socioeconomic level of individuals receiving insulin."
According to the scientists, these results demonstrate that "both age and sex govern response to A-HgM exposure to alter MS risk profiles."
Understanding the neuro-immunological changes that take place throughout the [near-to-menopause] transition and how these changes may impact brain health and illness risk in aging populations will become more relevant, they said.
