The Prevalence of Diabetes Mellitus Type II (DMII) in the Multiple Sclerosis Population: A Systematic Review and Meta-Analysis

Abstract

Introduction: The interactions between Diabetes Mellitus type II (DMII) and Multiple Sclerosis (MS) lead to higher levels of fatigue, higher risk of physical disability, faster cognitive decline, and in general a lower quality of life and a higher frequency of depression compared to the general population. All of the above accelerate the disability progression of patients with MS, reduce the patients’ functional capacity, and further increase their psychological and economic burden. Methods: This systematic review and meta-analysis aims to calculate the prevalence of DMII in the MS population. Following PRISMA guidelines, a thorough search of the Medline Pubmed, Cochrane Library, and Scopus databases was performed, focusing on the frequency of DMII in the MS population. Results: A total of 19 studies were included in the synthesis. The results of the main meta-analysis of random effects using R studio 3.3.0 for Windows and the Meta r package showed that the prevalence of DMII in the MS population is 5% (95% CI [0.03, 0.07], 19 studies, I2 = 95%, pQ < 0.001). Additional subgroup analysis based on region showed a difference of 4.4% (I2 = 95.2%, pQ < 0.001), psubgroupdifference = 0.003) between European and non-European participants, while demographic- and MS-specific characteristic (EDSS, Disease Duration) did not seem to affect the prevalence of DMII in the MS population (p = 0.30, p = 0.539, p = 0.19, p = 0.838). No publication bias was discovered (Egger’s p test value: 0.896). Conclusions: Even though the prevalence of DMII in the MS population is lower than 10% (the reported prevalence of DMII in the general population) the interactions between the two conditions create significant challenges for MS patients, their caregivers, and physicians. DΜΙΙ should be systematically recorded in the case of MS patients to clearly delineate any potential relationship between the two conditions. Additionally, more structured studies investigating the interactions of MS and DMΙΙ as well as the direction of the causation between those two conditions are necessary in order to gain a deeper insight into the nature of the interaction between MS and DMII.

Prevalence and epidemiology of stroke in patients with multiple sclerosis: a systematic review and meta-analysis

“…These findings are in accordance with the results of prior population-based cohorts and registries that ascertain an increased risk of MS patients for cerebrovascular and cardiovascular diseases [ 12 , 31 ]. In particular, cardiovascular risk factors were documented with varying prevalence among patients with MS, with crude prevalence estimates for hypertension of 18.2% (95% CI 5.9–35.3%), diabetes: 5.4% (95% CI 2.1–10.2%) and dyslipidaemia: 11.5% (95% CI 2.9–24.7).…”

“…For each dichotomous outcome of interest, the pooled prevalence with 95% confidence intervals (95% CI) was calculated for the aggregate meta-analysis, after the implementation of the Freeman–Tukey variance-stabilizing double arcsine transformation [ 12 – 14 ]. The random-effects model of meta-analysis (DerSimonian and Laird) was utilized for estimation of the pooled estimates [ 15 ].…”

Waist Circumference and Body Mass Index as Predictors of Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-Analysis

“…Notably, research indicates that WC more accurately predicts cardiovascular risk and T2DM in PwMS compared to the BMI, which underestimates adiposity in these patients [ 46 , 47 ]. Moreover, multiple studies have demonstrated a significant association between an increased WC and elevated risks of cerebral small vessel disease, T2DM, and neurological disability [ 48 , 49 ]. Consequently, WC emerges as a more accurate prognostic indicator of the cardiovascular burden in PwMS, which has been linked to an elevated risk of cerebral small vessel disease and neurological disability.…”

Potential molecular mechanism of exercise reversing insulin resistance and improving neurodegenerative diseases

“…Conversely, certain studies have demonstrated that glucose control in patients with MS was not enhanced after 24 weeks of combined endurance and resistance training (Wens et al, 2015). Although the prevalence of type II diabetes mellitus (T2DM) in the MS population is <10%, it rate is still higher than that in the general population (Giannopapas et al, 2023). Moreover, patients with T2DM in the MS population display significantly reduced levels of insulin secretion compared to that of patients without T2DM (Katsuki et al, 1998).…”