Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.
If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.
This week’s study is…
Age and sex differences on anti-hyperglycemic medication exposure and risk of newly diagnosed multiple sclerosis in propensity score matched type 2 diabetics
We previously published about this research in a story titled “Anti-Hyperglycemic Medication Increases MS Risk in Adults with Type 2 Diabetes” which can be found here. The study was originally published in the research journal Heliyon. You can read the full text of the study here.
This research team was affiliated with the University of Arizona Center for Innovation in Brain Science.
What Happened?
Type 2 diabetes is a serious health concern that is seeing increased rates of diagnosis throughout the world, with low- and middle-income countries seeing the most dramatic increases. Anti-hyperglycemic medications (A-HgM) are a commonly used treatment in this disease that can be critical to controlling blood sugar levels in this disease. A recent study sought to determine if the use of these medications increased a patient’s risk of developing multiple sclerosis (MS), an autoimmune disease.
In people living with type 2 diabetes, there is a growing body of data which connects multiple sclerosis and metabolic conditions via a shared driver of increasing autoimmunity. It was from this research basis that the study in question was conducted. The data was drawn from US insurance claims, which included data from 151 million people. From this resource, the scientists identified 5 million people with type 2 diabetes and a diagnosis of late or early-onset MS.
The researchers then divided these patients into under 45 and over 45 age groups, as well as by sex. The researchers found that there was a stark age-divide that determined whether treatment with A-HgMs were a risk factor for multiple sclerosis or not. For patients under age 45, the use of these drugs to treat type 2 diabetes appeared to have a protective effect against the development of MS. In patients over age 45, A-HgM use was a risk factor for the disease, meaning that people in this age group using A-HgMs were more likely to develop MS.
The risk was slight, yet significant, in males and more significant in females. The study also found that insulin exposure in patients over 45 further increased risk. While the study did not list the specific A-HgM medications that the patients in the study were using, possible examples include metformin, SGLT2 inhibitors, sulfonylureas, acarbose, and sitagliptin, among others.
About Multiple Sclerosis
Multiple sclerosis is a neurological disease which is characterized by damage to the myelin sheath, a fatty, insulating, protective covering that surrounds nerve cells and allows them to communicate effectively. Although a precise cause has not been determined, multiple sclerosis is considered an autoimmune disease, in which a certain trigger, such as an infection, may cause the immune system to mistakenly attack healthy tissue. Smoking and certain genetic variants are also considered risk factors for the disease. Symptoms include blurred vision, double vision, blindness in one eye, numbness, abnormal sensations, pain, muscle weakness, muscle spasms, difficulty speaking and swallowing, mood instability, depression, loss of coordination, and fatigue. There are a number of treatments available for the disease, but no cure. Life expectancy for patients is slightly reduced. To learn more about multiple sclerosis, click here.
Why Does it Matter?
The risk factor identified in this study has significant implications for patients (and women especially) living with type 2 diabetes, and effectively means that patients that are managing diabetes with medication are at an increased risk of developing multiple sclerosis later in life. The results of this study also add further weight to prior research that has found links between metabolic conditions (like diabetes) and multiple sclerosis.
“Our findings reinforce the need for a precision medicine approach to preventing MS in these vulnerable populations.” – Kathleen Rogers, Ph.D., lead researcher, associate director of translational neuroscience, Center for Innovation in Brain Science
These findings also carry the implication that with increasing rates of diabetes type 2, rates of multiple sclerosis may begin to increase as well. It’s clear that further research is necessary in order to investigate the connection between these life-limiting, chronic illnesses and discover strategies for prevention.
