A recent University of Arizona Health Sciences study discovered that persons over 45 with Type 2 diabetes who were treated with anti-hyperglycemic drugs had a higher risk of multiple sclerosis, particularly among women, but people under 45 had a lower risk.
“Our findings reinforce the need for a precision medicine approach to preventing MS in these vulnerable populations,” said lead researcher Kathleen Rodgers, PhD, associate director of translational neuroscience at the Center for Innovation in Brain Science. MS is an unexpected autoimmune neurological condition that affects the central nervous system and causes significant physical and cognitive impairment.
It is estimated that about 1 million individuals in the United States and more than 2.8 million globally have MS. There is emerging evidence associating metabolic problems and MS in persons with Type 2 diabetes via a similar cause of increased autoimmune. This calls into question the influence of anti-hyperglycemic therapies, such as insulin, used to treat Type 2 diabetes on the prevalence of MS.
“Previous research has shown a neuroprotective effect of anti-hyperglycemic medications in Alzheimer’s disease and other related dementias,” Dr. Rodgers said. “For MS, we wanted to further examine age and sex differences, particularly among men and women under 45 with Type 2 diabetes.”
They discovered that males over 45 had a little higher risk of MS, but women over 45 had a significantly higher incidence of MS following anti-hyperglycemic treatment. In addition to age differences, the risk analysis by medication class revealed that insulin exposure in individuals over the age of 45 was linked with a higher risk compared to other treatments. Anti-hyperglycemic medication was found to be protective against the development of MS in patients under the age of 45. The study used a 151 million-person insurance claims database in the United States to identify more than 5 million people with Type 2 diabetes and either early-onset or late-onset MS.
To decipher the factors influencing MS risk in both populations, researchers split the data by age (patients diagnosed with Type 2 diabetes before or after the age of 45) and sex. The paper, “Age and sex differences on anti-hyperglycemic medication exposure and risk of newly diagnosed multiple sclerosis in propensity score-matched type 2 diabetics,” was published recently in the journal Heliyon.