Summary: Fibromyalgia affects about 2% of the population. And at the same time, insulin resistance is also quite common. New epidemiological data suggests that those living with insulin resistance are more likely to be living with fibromyalgia. Since doctors still do not fully understand the pathogenesis of fibromyalgia, this finding is relevant and a step forward. It means that managing insulin resistance could be a therapeutic approach to managing chronic fibromyalgia-associated chronic pains.
Fibromyalgia is among the leading causes of chronic pain and mood disorders. It causes widespread body aches, hyperalgesia, depression, fatigue, sleep issues, headaches, and more. Studies suggest that it affects about 2% of the population. The conditions are more common in females and those living with chronic ailments1.
However, there are many challenges in getting pain relief caused by fibromyalgia. First, it is still among the poorly understood conditions. Second, it is a diagnosis of exclusion, which means doctors would first exclude other known health disorders that may cause chronic body aches. Third, doctors are still unsure about what causes fibromyalgia.
Nonetheless, in recent years, understanding of fibromyalgia has improved. It appears that chronic ailments, autoimmune disorders, and other painful conditions may cause some changes in the brain leading to hyperalgesia. It means that neuroinflammation plays an important role in such difficult-to-explain chronic pains.
Here it is vital to understand that fibromyalgia is not just about body aches. It is also about altered appetite, changes in mood like depression, and other health issues.
However, doctors still have to develop a sufficient understanding of fibromyalgia. They still do not know what causes it and what is the exact underlying disease mechanism. This means that doctors struggle to treat the condition. Quite often, doctors would try different treatments before they can find something that works for their patients.
Since, these days, people are living with so many overlapping painful conditions, doctors think that diabetes and resulting insulin resistance may increase the risk of fibromyalgia.
Diabetes is one of the most common metabolic disorders, and yet it remains a poorly understood condition. Although there are many types of diabetes, most people live with type 2 diabetes (90% of cases). High diabetes symptoms are characterized by insulin resistance, which may slow down tissue regeneration and cause many complications.
Undoubtedly, those living with diabetes are more likely to experience chronic pain. Diabetes is the leading cause of diabetic peripheral neuropathy, diseases of large and small blood vessels, and more. It may cause changes in the working of the autonomic nervous system and more.
However, now studies suggest that insulin resistance may be one of the contributing factors to the rise of fibromyalgia. In one of the largest population-based studies, researchers analyzed the data of 4.4 million people. They analyzed the disease conditions that often coexist with fibromyalgia. In the study, researchers found that those living with fibromyalgia are much more likely to have diabetes compared to those who do not have the condition2.
We would not say this is a major finding, as fibromyalgia seems common in those with different health conditions. Nonetheless, it is a step forward in understanding the conditions. In addition, it confirms that those living with diabetes are at an increased risk of developing fibromyalgia.
It further shows that insulin resistance may be one of the contributing factors to the condition, which means that treating insulin resistance may have a role in managing the condition. It also highlights the importance of exploring the role of various hormones in treating chronic pains and fibromyalgia.
Moreover, it is worth understanding that insulin resistance also increases the risk of depression, sleep disorders, and other health issues found in those living with fibromyalgia.
It means that managing diabetes effectively in its early stages may have a role in fibromyalgia prevention. Additionally, there is an urgent need to explore the role of insulin sensitizers in pain reduction in those living with fibromyalgia. For example, drugs like metformin may help reduce blood sugar and are excellent insulin sensitizers with many health benefits like weight reduction.
By Gurpreet Singh Padda, MD, MBA, MHP