The use of metoclopramide and non-steroidal anti-inflammatory drugs (NSAIDs) during migraine attacks may be associated with insulin resistance in women with migraine, according to a study published in Pain Medicine.
In this cross-sectional study, 150 women with migraine (average age, 33.6) were enrolled. The weight, height, waist circumference, blood pressure, fasting glucose, fasting insulin, hemoglobin A1c (HbA1c) and lipid profile of participants were measured. Independent variables included age, migraine triggers, and medication use during attacks.
A total of 55% of study participants had insulin resistance. Menstruation-related migraine was more common in women who did not vs who did have insulin resistance (P =.032), and metabolic syndrome, obesity, and metoclopramide use were more common in participants with vs without insulin resistance (P =.024, P =.001, and P =.049, respectively). Patients with vs without insulin resistance were found to resort more often to migraine prophylactic treatment.
Of the migraine triggers evaluated, only menstruation was associated with insulin resistance. Mean fasting glucose, insulin, cholesterol, waist circumference, weight, and body mass index were all higher on average in participants with vs without insulin resistance, but there were no significant differences in mean HbA1c, total triglyceride, high-density lipoprotein, low-density lipoprotein, height, or blood pressure between the 2 groups.
Central obesity (odds ratio [OR], 6.368; P <.0001), metoclopramide treatment during attacks (OR, 6.894; P =.005), and NSAID use during attacks (OR, 2.675; P =.029) were associated with the presence of insulin resistance in migraine.
Limitations of this study include its retrospective design.
“We demonstrate for the first time an association between [insulin resistance] and metoclopramide and NSAIDs used for treatment of migraine attacks in [women]. Other studies must be performed to clarify the dosage and frequency of use, which may influence this association,” concluded the study authors.
Gur-Ozmen S, Karahan-Ozcan K. Factors associated with insulin resistance in women with migraine: A cross-sectional study [published online April 2, 2019]. Pain Medicine. doi:10.1093/pm/pnz055