Researchers link insulin resistance, fibromyalgia

Insulin resistance may be linked to fibromyalgia, a discovery that could change how forms of chronic pain are identified and managed, according to a new study by researchers at the University of Texas Medical Branch at Galveston, and published in the journal PLOS One.

In the study, researchers separated 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 reduced their pain levels.

Earlier studies discovered that insulin resistance causes dysfunction within the brain's small blood vessels. Since this issue is also present in fibromyalgia, the researchers investigated whether insulin resistance is the missing link in the disorder. They found 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.

The researchers identified patients who were referred to a subspecialty pain medicine clinic to be treated for widespread muscular or 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.

Fibromyalgia is one of the most common conditions causing chronic pain and disability. In the U.S., related healthcare costs are about $100 billion each year, according to the Centers for Disease Control and Prevention. Despite extensive research, the cause of fibromyalgia is unknown, and there is no specific diagnostics or therapies for this condition other than pain-reducing drugs.

Though the results are preliminary, they may lead to a shift on how fibromyalgia and related forms of chronic pain are treated, according to Miguel Pappolla, MD, PhD, professor of neurology and lead author of the study. The new approach, he said, has the potential to save billions of dollars to the healthcare system and decrease many peoples' dependence on opiates for pain management.