[Pubmed] Prevalence and Clinical Impact of Abnormal Glucose Metabolism in Immunotherapy-naive Myasthenia Gravis

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Intern Med. 2026 Sep 15. doi: 10.2169/internalmedicine.7438-26. Online ahead of print.

ABSTRACT

Objective Although experimental studies suggest that diabetes mellitus (DM) exacerbates immune dysregulation in myasthenia gravis (MG), its precise impact on clinical outcomes remains unclear. Therefore, we investigated the influence of pre-existing glucose metabolism abnormalities in immunotherapy-naïve patients with MG.Methods Abnormal glucose metabolism was defined as receiving DM treatment or a glycated hemoglobin A1c level ≥ 6.0%. The prevalence of glucose metabolism abnormalities was compared with that of the general Japanese population, and MG outcomes were assessed between patients with and without these abnormalities.Patients or Materials We retrospectively studied 108 immunotherapy-naïve MG patients initially presenting to Chiba University Hospital between 2016 and 2020.Results Twenty-eight patients (25.9%) had abnormal glucose metabolism, similar to that of the general population. The prevalence in late-onset MG (LOMG) was 37.3%, which also showed no significant difference from the general population aged ≥ 50 years (34.2%). In LOMG, the abnormal glucose metabolism group had significantly higher MG Activities of Daily Living (MG-ADL) scores at 1-year follow-up (median [range]: 1 [0-5] vs. 0 [0-3], p = 0.017). In generalized LOMG, the abnormal glucose metabolism group showed significantly higher MG Foundation of America classes at peak severity within 1 year (3 [2-5] vs. 2 [2-4], p ＜0.001), higher MG-ADL scores at 1-year follow-up (1 [0-5] vs. 0 [0-2], p = 0.027), and required higher maximum daily prednisolone doses within 1 year (30.0 [0-50.0] vs. 10.0 [0-50.0] mg, p = 0.026) and at 1-year follow-up (9.0 [0-20.0] vs. 3.8 [0-10.0] mg, p = 0.029).Conclusion Abnormal glucose metabolism may negatively affect the clinical course of MG. In our evaluable LOMG cohort, this negative impact was most prominent in generalized cases, in which patients showed less satisfactory clinical improvement and required higher corticosteroid doses.

PMID:42749642 | DOI:10.2169/internalmedicine.7438-26


Source: https://pubmed.ncbi.nlm.nih.gov/4274964 ... 1&v=2.20.1