Myasthenia gravis and diabetes mellitus: a 35-year retrospective study.
BACKGROUND
The most common treatment of myasthenia gravis is high-dose prednisolone administration and thymectomy. A well-known adverse effect of prednisolone is hyperglycemia, however, to date there is no such detailed report.


METHODS
We treated 325 myasthenia gravis patients in a recent 35 years period, and found 11 patients with diabetes mellitus. We compared these 11 diabetic patients with previously-reported cases.


RESULTS
These 11 patients did not have any antibody against beta-cells in the pancreas such as anti-glutamic acid decarboxylase antibody. In 10 of 11 patients diabetes mellitus was controlled with oral medications.


CONCLUSIONS
Myasthenic patients with diabetes mellitus could be classified into 2 groups, one group with positive organ-specific autoantibodies to many organs (with type 1 diabetes mellitus), and the other group with diabetes mellitus onset during prednisolone administration (with type 2 diabetes mellitus).
Wakata
Nobuo
N
Department of Neurology, Toho University School of Medicine, Oohashi Hospital, Tokyo, Japan. waka@etude.ocn.ne.jp
Nemoto
Hiroshi
H
Konno
Shinngo
S
Nakazora
Hiroshi
H
Nomoto
Nobuatsu
N
Sugimoto
Hideki
H
Kurihara
Teruyuki
T
D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000601:surgery; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D013934:Thymectomy / Q000009:adverse effects
D001323:Autoantibodies; D005938:Glucocorticoids; D007004:Hypoglycemic Agents; D011239:Prednisolone; D005968:Glutamate Decarboxylase