New research from Argentina explores the idea that controlling symptoms of type 2 diabetes (metabolic syndrome) can also beneficially impact multiple sclerosis (MS) disease progression. The study,“Immunologic Effects of Metformin and Pioglitazone Treatment on Metabolic Syndrome and Multiple Sclerosis,“ appeared March 7 in the journal JAMA Neurology.
Pioglitazone and metformin are oral medications used to treat type 2 diabetes. They can be used in combination with insulin to help control blood sugar levels, and may also have effects on reducing inflammation, which is a heightened immune response. MS is an autoimmune disease characterized by inflammation and immune cells attack to the body’s own myelin, an insulating substance that helps nerve cells to conduct impulses. There is increasing evidence that neuron death and loss of the axons that extend from neurons also occurs in MS, due to inflammation.
Having type 2 diabetes in addition to MS could greatly increase inflammation and exacerbate both the symptoms and the progression of the disease. In people with both diseases, controlling type 2 diabetes may help with MS symptoms.
Researchers, led by Laura Negrotto of the Department of Neurology, Dr. Raúl Carrea Institute for Neurological Research, Buenos Aires, wanted to know whether disease activity could be reduced by metformin and/or pioglitazone in patients with MS and metabolic syndrome (type 2 diabetes). To examine MS-associated lesions, they used magnetic resonance imaging (MRI). Researchers also analyzed blood markers for MS.
The research team studied a total of 50 MS and diabetic patients, with 20 of them being treated with metformin and 10 under pioglitazone treatment. The remaining 20 patients served as controls.
After six months, findings showed that both treatments resulted in a significant decrease in new or expanding MS-associated lesions. The treatments also reduced immune system markers that are typical of MS, including immune system cells and their production of molecules known as cytokines.
The researchers concluded, “Treatment with metformin and pioglitazone has beneficial anti-inflammatory effects in patients with MS and [metabolic syndrome] and should be further explored.”
Based on the study, clinicians with patients who have both MS and metabolic syndrome may consider the importance of treating metabolic syndrome and high blood sugar, based on its impact on MS disease progression.