Objective:

To investigate the neuroprotective potential of insulin mimetics (IM) in patients with neuro autoimmune disease (NAD) and high risk comorbidities. 

Background:

IM are used to treat patients with diabetes mellitus (DM) and have been shown to protect against progressive neurological damage. Despite their neuroprotective benefits, the extent of their neuroprotection in patients with NAD has not been completely characterized. 

Design/Methods:

A retrospective analysis on 34464 patients hospitalized at a tertiary care center in a major metropolitan area was conducted. 168 patients were taking IM medications. 7848 patients were taking medicine other than IM for their DM (nIM). 7690 patients were taking insulin without IM medications. 26448 patients were not on any DM medication (nDM). The outcomes compared included the prevalence of NAD, diabetic neuropathy and/or retinopathy (DMNR), and the prevalence of high risk comorbidities defined as those with either heart failure, chronic kidney disease, stroke, or encephalopathy. 

Results:

The prevalence of NAD was 0.6%, 0.52%, 0.53%, 0.56% among patients in the IM, nIM, insulin, and nDM groups respectively (p>0.05). 19.5% of NAD and 23.6% of those without NAD had high risk comorbidities (p>0.05). Among those with autoimmune disease, 31% of those taking any diabetic medication and 16% of nDM had high risk comorbidities (p>0.05). The prevalence of DMNR was 10% and 8% in IM and nIM groups respectively (p>0.05).

Conclusions:

These results suggest that IM medications may benefit patients with NAD against additional comorbidity as those without NAD and DM are expected to have less high risk disease. However, more studies are needed to determine whether IM medications play a role in neuro-autoimmune disease progression and mortality.