The link between diabetes drugs and multiple sclerosis
Summary: People over the age of 45 who use antihyperglycemic drugs to control type 2 diabetes have an increased risk of developing multiple sclerosis. However, those who are younger than 45 and taking antihyperglycemic drugs have a reduced risk of MS.
Source: University of Arizona
A new study from the University of Arizona Health Sciences found that people older than 45 whose type 2 diabetes was treated with antihyperglycemic drugs had an increased risk of multiple sclerosis, especially among women, while antihyperglycemic exposure in people younger than 45 reduced that risk. .
“Our findings reinforce the need for a precision medicine approach to MS prevention in these vulnerable populations,” said lead researcher Kathleen Rodgers, Ph.D., associate director of translational neuroscience at the Center for Brain Science Innovation.
Multiple sclerosis (MS) is an unpredictable autoimmune neurological disorder that affects the central nervous system and leads to severe physical and cognitive disability. It is estimated that nearly 1 million adults in the US and more than 2.8 million worldwide are living with MS.
For people with type 2 diabetes, there is increasing evidence linking metabolic disorders and MS through a common trigger of increased autoimmunity. This calls into question the impact of antihyperglycemic therapies used to treat type 2 diabetes, including insulin, on the incidence of MS.
“Previous research has shown the neuroprotective effect of antihyperglycemic drugs in Alzheimer’s disease and other related dementias,” said Dr. Rodgers. “For MS, we wanted to further examine age and gender differences, particularly among men and women under 45 with type 2 diabetes.”
They found that men over 45 years of age had a marginally significant increase in the risk of MS, and women over 45 years of age showed a significant increase in the incidence of MS after exposure to antihyperglycemia. In addition to differences in age, risk analysis by drug class showed that exposure to insulin in patients older than 45 years was associated with a greater increased risk compared to other therapies.
In patients younger than 45 years, antihyperglycemic exposure was protective against the development of MS.
The study used a US-based insurance database of 151 million participants to identify more than 5 million patients diagnosed with type 2 diabetes and either early-onset or late-onset MS. The researchers segmented the data by age—patients diagnosed with type 2 diabetes before or after age 45—and gender to decode the factors that influence the risk of MS in both populations, particularly in women over 45.
The paper, “Age and Gender Differences in Antihyperglycemic Drug Exposure and Risk of Newly Diagnosed Multiple Sclerosis in Propensity-matched Type 2 Diabetics,” was recently published in the journal Hellion.
Co-authors from the Center for Innovation at Brian Science are Roberta Diaz Brinton, PhD, director and Regents Professor; Dr. Franceska Vitali, research assistant professor of neurology; Georgina Torrandell-Haro, PhD student and graduate research assistant; and Gregory Branigan, PhD, a third-year medical student in the UArizona College of Medicine – Tucson’s MD-PhD program.
funding: This research was supported in part by the National Institute on Aging (P01AG026572, T32AG061897, R37AG053589) and the National Institute of Neurological Disorders and Stroke (R25NS107185), both divisions of the National Institutes of Health.
About this multiple sclerosis and diabetes research
Original Research: Open access.
“Age and gender differences in antihyperglycemic drug exposure and risk of newly diagnosed multiple sclerosis in propensity score matched type 2 diabetics” by Kathleen Rodgers et al. Hellion
Age and gender differences in antihyperglycemic drug exposure and risk of newly diagnosed multiple sclerosis in propensity score matched type 2 diabetics
The relationship between exposure to antihyperglycemic drugs (A-HgM) for the treatment of type 2 diabetes mellitus (T2D) and multiple sclerosis (MS) in patients with T2D is unclear.
This retrospective cohort analysis used the Mariner claims database. Patient data were examined for MS diagnosis beginning 12 months after T2D diagnosis. Patients were required to be actively enrolled in the Mariner claims registry six months before and at least three years after T2D diagnosis with no history of previous neurodegenerative disease. Survival analysis was used to determine the association between A-HgM exposure and MS diagnosis. A propensity score approach was used to minimize measured and unmeasured selection bias. The analyzes were performed from January 1 to April 28, 2021.
In T2D patients younger than 45 years, exposure to A-HgM was associated with a reduced risk of developing MS (RR: 0.22, 95%CI: 0.17–0.29, p-value <0.001). Conversely, exposure to A-HgM in patients older than 45 years was associated with an increased risk of MS in women who showed a higher risk (RR: 1.53, 95%CI: 1.39–1.69, p < 0.001) than men (RR: 1.17, 95 %CI: 1.01–1.37, p = 0 · 04). Patients who developed MS had a higher incidence of initial comorbidities. The mean duration of follow-up was 6.2 years with a standard deviation of 1.8 years.
In this study, A-HgM exposure in patients with T2D was associated with a reduced risk of MS in patients younger than 45 years, while in patients older than 45 years, A-HgM exposure was associated with an increased risk of newly diagnosed MS, especially in a woman. .
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