TUCSON, Ariz. – A new study from the University of Arizona Health Sciences has found that people over the age of 45 whose type 2 diabetes is treated with anti-hyperglycemic drugs have an increased risk of multiple sclerosis. plaque, particularly in women, while exposure to anti-hyperglycemics in people under 45 reduces this 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.
Multiple sclerosis (MS) is an unpredictable autoimmune neurological disease that affects the central nervous system and leads to severe physical and cognitive disabilities. It is estimated that nearly one million adults in the United States and more than 2.8 million worldwide live with MS.
For people with type 2 diabetes, there is growing evidence linking metabolic disorders and MS through a common factor of increased autoimmunity. This calls into question the impact of anti-hyperglycemic therapies used to treat type 2 diabetes, including insulin, on the incidence of MS.
“Previous research has shown a neuroprotective effect of antihyperglycemic drugs in Alzheimer’s disease and other related dementias,” Dr. Rodgers said. “For MS, we wanted to look in more detail at age and sex differences, particularly in men and women under 45 with type 2 diabetes.”
They found that men over 45 had a slightly significant increased risk of MS and women over 45 had a significantly increased incidence of MS after exposure to anti-hyperglycemics. In addition to age differences, risk analysis by drug class showed that insulin exposure in patients over 45 was associated with a greater increased risk compared to other therapies.
In patients under 45 years of age, exposure to anti-hyperglycaemics protected against the development of MS.
The study used a US-based insurance claims database of 151 million participants to identify more than 5 million patients diagnosed with type 2 diabetes and early or late-onset MS. The researchers segmented the data by age (patients diagnosed with type 2 diabetes before or after age 45) and by sex to decode risk factors for MS in both populations, particularly among women over age 45.
The article, “Age and sex differences in antihyperglycemic drug exposure and risk of newly diagnosed multiple sclerosis in propensity score-matched type 2 diabetics,” was recently published in the Heliyon magazine.
Co-authors from the Center for Innovation in Brian Science include Roberta Diaz Brinton, PhD, Director and Regents Professor; Francesca Vitali, PhD, assistant research professor of neurology; Georgina Torrandell-Haro, PhD student and graduate research assistant; and Gregory Branigan, PhD, a third-year medical student at the UArizona College of Medicine – MD-PhD program in Tucson.
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), two divisions of the National Institutes of Health.