Does Insulin Resistance Cause Fibromyalgia?

Fibromyalgia is one of the most common conditions causing chronic pain and disability. The global economic impact of fibromyalgia is enormous – in the U.S. alone and related health care costs are about $100 billion each year. Despite extensive research the cause of fibromyalgia is unknown, so there’s no specific diagnostics or therapies for this condition other than pain-reducing drugs. A newly confirmed link with insulin resistance may radically change the way fibromyalgia and related forms of chronic pain are identified and managed.


Researchers led by a team from The University of Texas Medical Branch at Galveston were able to dramatically reduce the pain of fibromyalgia patients with medication that targeted insulin resistance.

This discovery could dramatically alter the way that chronic pain can be identified and managed. Dr. Miguel Pappolla, UTMB professor of neurology, said that although the discovery is very preliminary, it may lead to a revolutionary shift on how fibromyalgia and related forms of chronic pain are treated. The new approach has the potential to save billions of dollars to the health care system and decrease many peoples’ dependence on opiates for pain management.

The UTMB team of researchers, along with collaborators from across the U.S., including the National Institutes of Health, were able for the first time, to separate patients with fibromyalgia from normal individuals using a common blood test for insulin resistance, or pre-diabetes. They then treated the fibromyalgia patients with a medication targeting insulin resistance, which dramatically reduced their pain levels. The study was recently published in PlosOne.

“Earlier studies discovered that insulin resistance causes dysfunction within the brain’s small blood vessels. Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder,” Pappolla said. “We showed that most – if not all – patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past two to three months.”

Pre-diabetics with slightly elevated A1c values carry a higher risk of developing central (brain) pain, a hallmark of fibromyalgia and other chronic pain disorders.”

The researchers identified patients who were referred to a subspecialty pain medicine clinic to be treated for widespread muscular/connective tissue pain. All patients who met the criteria for fibromyalgia were separated into smaller groups by age. When compared with age-matched controls, the A1c levels of the fibromyalgia patients were significantly higher.

“Considering the extensive research on fibromyalgia, we were puzzled that prior studies had overlooked this simple connection,” said Pappolla. “The main reason for this oversight is that about half of fibromyalgia patients have A1c values currently considered within the normal range. However, this is the first study to analyze these levels normalized for the person’s age, as optimal A1c levels do vary throughout life. Adjustment for the patients’ age was critical in highlighting the differences between patients and control subjects.”

For the fibromyalgia patients, metformin, a drug developed to combat insulin resistance was added to their current medications. They showed dramatic reductions in their pain levels.

There are a number of limitations to make here. This is a preliminary study using only a small number of fibromyalgia patients, so it’s not clear if insulin resistance tests and metformin treatment would work for every person with fibromyalgia, or what exactly the relationship between insulin resistance and fibromyalgia is. More research needs to be done, but in the meantime, these results offer some hope for people looking for relief from chronic pain.

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Metformin is used with a proper diet and exercise program and possibly with other medicationsto control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body’s proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb. – Web MD

Side Effects

Nausea, vomiting, stomach upset, diarrhea, weakness, or a metallic taste in the mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If stomach symptoms return later (after taking the same dose for several days or weeks), tell your doctor right away. Stomach symptoms that occur after the first days of your treatment may be signs of lactic acidosis.


Before taking this medication, tell your doctor or pharmacist if you are allergic to metformin; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), kidney disease, liver disease.


Connection between diabetes and fibromyalgia

FMS (Fibromyalgia syndrome) literally means pain in the fibrous tissues, the most common symptoms being widespread musculoskeletal pain and fatigue. The disorder has only gained increasing recognition in the past twenty years but unfortunately, the causes of Fibromyalgia remain unknown.

Diabetes and Fibromyalgia syndrome are linked conditions. There have been studies that have evaluated concomitant conditions occurring with fibromyalgia. One aspect is to look for the association of fibromyalgia with diabetes mellitus. One such study looked at the prevalence of diabetes type 1 and type 2 among patients with fibromyalgia.

Did you realize that fibromyalgia and diabetes occur almost four times more often than you’d ever dream of expecting? Research has shown that keeping a tight rein on the blood sugar levels of diabetic patients actually greatly reduces the risk of the individual developing fibromyalgia at some point in their lives. Around 15 to 18 percent of diabetic patients also have fibromyalgia shown by a study done in the journal Rheumatology International.

The connection between tow was much stronger in those individuals who had type 1 diabetes than for those that had type 2 diabetes- though the association between fibromyalgia and diabetes was much higher in those with type 2. Diabetes was freedom. With discipline around nutrition and insulin doses, and endless learning around exercise physiology, anything was possible with diabetes. Anything. Type 1 diabetics have climbed Mt. Everest, completed Ironman races, cycled 100 miles, and won the Olympics.

Interestingly, controlling blood sugar levels can also dictate the likelihood of developing fibromyalgia. The connection between both diseases is due to the levels of hemoglobin A1C among diabetic patients. The reason this association is so interesting is because type 1 diabetes is considered to occur due to an autoimmune disease, though the trigger is not exactly known.

Due to the fact that it is strongly associated with fibromyalgia and it is an autoimmune disease suggests that those who support that autoimmunity cause’s fibromyalgia could be headed in the right direction. Of course, before this is officially established, more research must be done. It was determined that the higher the hemoglobin A1C levels of a diabetic patient is, the more likely he or she will suffer from fibromyalgia.

Hemoglobin A1C is blood chemical used to measure how well high your blood sugar was on average during the past 3 months. How they both seem to react to blood sugar levels is another link between these two disorders. An increase of blood glucose also indicates the severity of the symptoms associated with the two health issues.

Furthermore patients who have both diabetes and fibromyalgia have a higher number of tender points, increased pain scores, increased risk of sleep disturbances, fatigue, and headaches. Prevalence of Juvenile Fibromyalgia in children with Type 1 Diabetes Mellitus was assessed by an important study. Results showed that fibromyalgia was more common in children with type 1 diabetes. These patients also had more severe pain, more fatigue and sleep impairment.



Patients who already are dealing with diabetes in those reaching a diagnosis of fibromyalgia can be very difficult. This is because diabetes can actually mimic any or all of the symptoms that are associated directly with fibromyalgia. The only way to truly reach a diagnosis is through true clinical testing of the symptoms .

Due to the fact that there is no test that can truly demonstrate the presence of fibromyalgia.  Especially female patients who are suffering from diabetes must be aware that fibromyalgia actually occurs at a rate of four times more in those who have diabetes than is seen in the general public.

Those symptoms that don’t get better when blood sugar levels are under control and they are connected with diabetes should be looked at more closely because they could point to fibromyalgia. If you have poured all your efforts to get your blood sugar controlled yet your body seems to be less responsive, you have to go back to your doctor right away to get more clinical tests done.

Be mindful of your body pains and other symptoms you may feel. This means that if your blood sugar is uncontrolled, headaches, tender points, insomnia, and fatigue are more likely to happen to you. In severe cases, patients with both disorders suffer from chronic body pain.

Sensory symptoms, such as shooting nerve pain, tenderness, and general pain is typically experienced in both conditions and it is the source of confusion between the symptoms of fibromyalgia and diabetes. Following information was revealed after the combination of symptoms. Attacks and pressure points were three times more likely to be caused by fibromyalgia than diabetes.

Attacks and numbness were twice as likely to be caused by diabetes as fibromyalgia. Thermal and pressure points were twice as likely to be caused by fibromyalgia as diabetes. Burning, pressure, and attacks showed a slight difference in cause, favoring fibromyalgia as the cause over diabetes. Prickling and numbness were three times more likely to be caused by diabetes instead of fibromyalgia.


Both have different treatments but treating one can reduce the symptoms of the other condition. For example controlling blood sugar has a significant impact on fibromyalgia. Pain levels, the amount of disturbances in sleep, and fatigue associated with fibromyalgia can considerably reduced after managing your diabetes.

Exercise can improve both conditions. The need of insulin and danger of reaching high levels of blood sugar can be reduced by exercise.  Heart disease and stroke that are common among the population suffering from diabetes can also be prevented by exercise.

In regard to many different diseases Aerobic exercise actually has many different benefits. Individuals suffering from both conditions should remember that treating both of them together is the best way to ensure maximum recovery.

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