Multiple sclerosis (MS) is an unpredictable autoimmune neurological disorder that affects the central nervous system and leads to severe physical and cognitive disability. Recent research from the Arizona University of Health Sciences published in ‘Heliyon’ explored the impact of anti-hyperglycemic therapeutics used to treat Type 2 diabetes (T2D), including insulin, on the incidence of MS.

The study utilized a U.S.-based insurance claims database of 151 million participants to identify more than 5 million patients with a diagnosis of T2D and either early-onset or late-onset MS. Researchers segmented the data by age; patients diagnosed with T2D prior to or after age 45 and sex to decode the factors driving MS risk in both populations, especially in women over 45 years of age.

In patients with type 2 diabetes younger than 45, anti-hyperglycemic medications (A-HgM) exposure was associated with a reduced risk of developing MS (RR: 0.22, 95%CI: 0.17–0.29, p-value <0.001). In contrast, A-HgM exposure in patients older than 45 was associated with an increased risk of MS with women exhibiting greater 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 baseline comorbidities. The mean follow-up was 6.2 years with a standard deviation of 1.8 years.

The study highlights that A-HgM exposure in patients with T2D was associated with a reduced risk of MS in patients younger than 45 whereas, in patients older than 45, exposure to A-HgM was associated with an increased risk of newly diagnosed MS, particularly in women.