MG and Diabetes

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: January 2024

There is a complex link between myasthenia gravis (MG) and type 2 diabetes. The body’s immune system plays a role in both MG and diabetes. Research suggests that people with diabetes have an increased chance of developing MG. And people with diabetes may have worse MG symptoms compared to people without diabetes.^1-3

On the other hand, some drugs used to treat MG may increase a person’s chances of developing type 2 diabetes.^1-3

Diabetes as a risk factor for MG

Statistics show people with type 2 diabetes may have a higher risk of developing MG. The exact reason for this is unknown. A 2023 study that looked at a group of people with MG found that about 1 in 4 people with MG also had type 2 diabetes. Most of these people had developed diabetes years before developing MG.¹

MG as a risk factor for diabetes

People with MG have a higher chance of developing type 2 diabetes. One possible reason for this is the use of steroids as a treatment.³

Steroids (corticosteroids) are a type of hormone used to treat many diseases. They are sometimes used to treat symptoms of MG. But steroids can make it difficult to maintain normal blood sugar levels.^3,4

Researchers think that steroids change the way your body responds to insulin. Insulin is an important hormone that controls the amount of sugar in your blood. Steroids can decrease the amount of insulin your body is producing or make you less sensitive to insulin. This causes the amount of sugar in the blood to increase. Extended courses of steroids may increase your chances of developing type 2 diabetes, particularly if you already have other risk factors. ^3,4

For people who already have type 2 diabetes, taking steroids can make it harder to control blood sugar levels. For people without type 2 diabetes, taking steroids may increase the risk of developing type 2 diabetes. Even extended use of steroid cream on your skin may increase your chances of developing type 2 diabetes.^4,5

Dealing with high blood sugar levels

If you notice an increase in your blood sugar levels, talk to your doctor. The possible remedy will depend on the type and amount of steroid that you are taking. As a result, the best treatment options will be unique for each person.⁴

For some people, eating a healthy diet and increasing physical activity can lower blood sugar. But these changes may not be enough. In these cases, doctors may prescribe drugs that can lower blood sugar levels.⁴

Insulin helps your body use the sugar in the blood. Some drugs used to treat high blood sugar try to increase the amount of insulin the body produces. Types of these drugs include:⁴

Sulfonylureas – One example is gliclazide.
Glinides – These drugs work fast and for a shorter amount of time than sulfonylureas. This makes them less likely to lower blood sugar too much.

Steroids make your body less sensitive to insulin. This causes sugar to stay in the blood, increasing blood sugar levels. To offset the effect of steroids, certain drugs can be used to increase sensitivity to insulin. These drugs include:⁴

Metformin
Thiazolidinediones

Insulin therapy is another option. This involves directly injecting insulin into the body to reduce blood sugar. The amount of insulin and how often it is injected depends on current blood sugar levels and lifestyle.⁴

Depending on your symptoms, your doctor may prescribe steroids as a treatment for MG. In that case, it is helpful to track your blood sugar levels with a blood sugar monitor. High blood sugar can cause many health problems. Tracking your blood sugar will allow you to begin to reduce your blood sugar levels as soon as possible.

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Jswope50 Member
I have found using a Continuous glucose monitor (CGM) to be the only reliable way to monitor my glucose levels while going through multiple medication changes for my MG and type 2 diabetes. First, anyone on Medicare should know that in late 2023 changes in coverage for CGMs went into effect. The changes make it possible for non-insulin users to get coverage under Medicare. There are some specific conditions that must be met, but if you qualify you can get some or all of the cost covered. In my case, I was denied at first because my healthcare team didn't fully report my qualifying events. That was corrected on the second submittal (with careful coaching from me) and I am now fully covered. I like many MGers was put on Prednisone which caused elevated glucose levels (BGL). Then I was given various different meds at varied dosages in an effort to control my BGL. Once those meds would kick in, my BGL would go dangerously low. These hypoglycemic events would generally happen late at night, for me. Because of the inconvenient timing of my events I only found out about them by accident the first time and quickly realized I needed to be more proactive with my BGL monitoring. This lead my to purchasing my first few CGM sensors on my own (did require a prescription). My doctor told me that CGMs are not covered by Medicare, for non insulin users. I soon learned that, that information was no longer true. Once I started using the CGM I learned that I was having many hypoglycemic events (which ultimately qualified me for coverage under Medicare). The CGM reads and reports my levels every minute and sends alerts to my phone when I get dangerously low or high. This allows me to see in real time the effect of medication changes and how different foods interact with those meds relative to my BGL. I am happy that I spent the $300 out of my pocket to get the information I needed to be able to intelligently manage my BGL while going through multiple medication changes. Without this initial expense I also would not have found out that I qualified for coverage under Medicare.
CommunityMembereb5c0f Member
Cool article but needs more information 💁‍♀️ 😀 
1. Julie.Byers Community Admin
 <inline-mention username="CommunityMembereb5c0f" user-id="8860654"/> we appreciate you taking the time to share your feedback. Is there any information in particular that you were interested in learning more about or that you felt like was missing? -Julie (team member)