Posted on May 07, 2019, 7 p.m.
In collaborative efforts led by University of Texas research has confirmed a link between insulin resistance and fibromyalgia that may change the way forms of chronic pain are identified and managed.
The team was able to dramatically reduce the pain of fibromyalgia patients by using medication that targets insulin resistance, metformin, the approach has potential to save billions in the healthcare system and decrease opiate dependency for pain management.
For the first time patients suffering with fibromyalgia were able to be separated from those in otherwise pain free good health by using a common blood test typically used for insulin resistance or prediabetes testing. Those with fibromyalgia were then treated with a medication that targets insulin resistance which was observed to reduce their pain levels.
Among conditions causing chronic pain and disability fibromyalgia is one of the most common, the global economic impact is huge, within the USA alone related healthcare costs are estimated to be $100 billion per year. Cause of the condition remains unknown despite extensive research, currently there are also no known specific diagnostics or therapies other than opiates.
"Earlier studies discovered that insulin resistance causes dysfunction within the brain's small blood vessels. Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder," says Dr. Miguel Pappolla. "We showed that most -- if not all -- patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past two to three months."
"Considering the extensive research on fibromyalgia, we were puzzled that prior studies had overlooked this simple connection," said Pappolla. "The main reason for this oversight is that about half of fibromyalgia patients have A1c values currently considered within the normal range. However, this is the first study to analyze these levels normalized for the person's age, as optimal A1c levels do vary throughout life. Adjustment for the patients' age was critical in highlighting the differences between patients and control subjects."
The identified patients were referred to a subspecialty pain medicine clinic to be treated for widespread muscular and connective tissue pain; those meeting the criteria for fibromyalgia were divided into smaller groups by age, when compared to matched controls A1c levels of fibromyalgia patients were found to be significantly higher.
Those with fibromyalgia were given metformin, a drug developed to combat insulin resistance, to add to their current medication regimen which was found to dramatically reduce their pain levels.
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