Researchers Find Lower Risk of Type 2 Diabetes Among Women With Migraine

Despite being associated with hyperlipidemia, hypertension, and cardiovascular disease events, migraine is linked to a lower risk of developing type 2 diabetes among women, according to a new study.

Prior to the study, it was hypothesized that because migraine has been associated with factors associated with insulin resistance and type 2 diabetes, it would also be associated with an increased risk of diabetes.

However, the study found an approximate 30% decrease in the risk of developing diabetes based on an analysis of 74,247 women who were part of the French Etude Epidémiologique Auprès des Femmes de la Mutuelle Générale de l’Education Nationale study initiated in 1990. The women completed self-administered questionnaires every other year and were followed up between 2004 and 2014.

Compared to women with no history of migraine, women who reported active migraine were younger, had a lower level of physical activity, were more likely to have a family history of diabetes, were more likely to use oral contraceptives, and were more likely to be former smokers.

Women with prior migraine were also younger, more likely to have a family of history of diabetes, and more likely to use oral contraceptives compared with women with no history of migraine. However, unlike women with active migraine, they were more likely to have a history of hypertension, be overweight, and have never smoked compared with women with no history of migraine.

During the 10-year period, 2372 women experienced incident cases of type 2 diabetes. The analysis showed a lower risk of incident type 2 diabetes among women with active migraine compared with women with no migraine history (HR .80; 95% CI, 0.60-0.96), and the magnitude of the association was increased in multivariable-adjusted models (HR .70; 95% CI, 0.58-0.85). However, prior migraine was not associated with the risk of type 2 diabetes, even in the multivariable-adjusted models.

“There was a clear linear decrease in the 2-year prevalence of active migraine from 24 years from diagnosis to the date of diagnosis,” added the researchers. “After type 2 diabetes diagnosis, there was a plateau in the prevalence of active migraine that persisted up to 22 years after diagnosis. The magnitudes of the estimates were not sensitive to adjustment for time-varying covariates.”

As both migraine and type 2 diabetes are highly prevalent, these results can have substantial implications for understanding the mechanisms underlying the 2 conditions, they added. They hypothesize that because plasma glucose concentration rises with time up to the point of type 2 diabetes occurrence, the prevalence of migraine symptoms may decrease. Consequently, they wrote, the evolution and especially the decrease of migraine frequency in those with migraine at high risk of diabetes, such as those with obesity, irrespective of age, could be a sign of an emerging increased blood glucose levels, prediabetes, or type 2 diabetes.

Reference

Fagherazzi G, Fatouhi D, Fournier A, et al. Associations between migraine and type 2 diabetes in women [published December 17, 2018]. JAMA Neorol. doi: 10.1001/jamaneurol.2018.3960.