The Relationship between Multiple Sclerosis Relapse Recovery and Blood Glucose Response to Intravenous Methylprednisolone

• Published in: QJM : An International Journal of Medicine Vol. 117; no. Supplement_2
• Main Authors: Abd El-Aziz, Azza Abd El-Nasser, Nassef, Ayman Mohamed Ahmed, El- Hafeez, Mohammed Aly Abd, Michael, Joseph Francis Gerges
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2024
• Subjects: intravenous methylprednisolone; Multiple sclerosis; relapsing-remitting multiple sclerosis
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcae175.520

Background The study investigated the relationship between random blood sugar (RBS) levels and clinical outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) following intravenous methylprednisolone (IVMP) treatment. Objective Determine the relationship between blood glucose level during intravenous methylprednisolone (IVMP) treatment and the degree of motor & cognitive recovery afterwards in relapsing remitting multiple sclerosis patient. Subjects and Methods This observational analytical prospective study was conducted on 40 patients with relapsing remitting multiple sclerosis (RRMS) at Nasr city hospital of health insurance – Ain Shams University Hospital between May 2022 and November 2022. The study population was adults with confirmed diagnosis of relapsing-remitting multiple sclerosis who are currently experiencing a relapse. Patients with other neurological diseases, cognitive disorders, diabetes, certain medications, learning disabilities, or who are pregnant or using hormone replacement therapy are excluded. The study tools for this study include a clinical assessment of MS patients, the use of the Expanded Disability Status Scale (EDSS) to assess motor deficit, the use of the Symbol Digit Modalities Test (SDMT) to assess cognitive function, and the measurement of fasting blood glucose. The purpose of these study tools is to assess the effects of IVMP induced hyperglycemia on motor & cognitive relapse recovery in relapsing remitting multiple sclerosis patients. Results The study sample included 40 patients with definite RRMS, and the primary outcome measure was EDSS. The study found that hyperglycemia may be a potential predictor of poor treatment response in MS patients. The study also identified cut-off values for RBS levels that can predict the probability of recovery after IVMP treatment. The significant relationship between older age of onset and poorer SDMT performance supports previous research that has found age to be a risk factor for cognitive decline in MS. Similarly, the significant relationship between longer duration of illness and poorer SDMT performance is consistent with previous studies that have found disease duration to be a predictor of cognitive impairment in MS. Conclusion The present study provides further evidence of the association between hyperglycemia and poor outcomes in patients with RRMS following IVMP treatment. The findings suggest that RBS levels may be a useful prognostic marker for predicting cognitive and functional outcomes in MS patients. Clinicians should consider monitoring and managing RBS levels in MS patients to optimize treatment outcomes. However, further studies are needed to elucidate the underlying mechanisms and to determine the optimal cut-off values for RBS levels in predicting MS outcomes.