Migraine: The connection between headaches and blood sugar levels
- New research sheds light on the genetic basis of the link between migraine and certain blood sugar-related traits, such as fasting insulin and glycated hemoglobin.
- The co-occurrence of headache, migraine, and blood sugar imbalance has been previously reported and there are shared links between migraine, headache, and blood sugar regulation. Additionally, several genes have been identified as risk factors for migraine.
- Now, researchers have identified a potential causal relationship that may pave the way for the development of new prevention and treatment options.
A new study, published in the journal Human Genetics, analyzed data from hundreds of thousands of human genomes from individuals with and without a history of migraine or headache.
Previous research has shown that there are several gene and biochemical pathways that are shared between migraine and headache and blood sugar-related traits, such as fasting insulin and glycated hemoglobin.
However, it was unclear how these conditions were genetically linked.
To investigate this relationship, researchers analyzed large-scale genetic data from European populations.
They looked for genetic similarities between migraine, headache, and nine blood sugar-related traits. They also identified regions of the genome that were linked to both types of conditions.
The researchers also suggested a potential causal relationship between increased fasting proinsulin levels and decreased risk of headaches.
Identifying genetic markers associated with migraine and headache
The researchers conducted a meta-analysis with blood sugar-related traits that they say identified six new genetic markers associated with migraine and headache, finding that certain genes were associated with these conditions.
They said these findings provide insights into the biological mechanisms underlying the comorbidity of these conditions.
Using a statistical technique called Mendelian randomization, the researchers explored the causal relationship between mechanisms and conditions.
They reported some evidence to suggest that increased fasting proinsulin levels may decrease the risk of headaches, but the evidence for a causal link between migraine and other blood sugar-related traits was less clear.
Overall, they said, these findings suggest that migraine, headache, and blood sugar-related traits may have a common genetic basis and provide insights into the ways that they contribute to their co-occurrence.
Md Rafiqul Islam, PhD, a study author and a student at the School of Biomedical Sciences at the Centre for Genomics and Personalized Health at Queensland University of Technology in Australia, spoke to Medical News Today about the research.
“Our study revealed a significant overlap between the genetic risk factors (e.g., genes and genetic variants) for migraine and blood sugar regulation, suggesting that these conditions have a common genetic basis,” Islam said. “Additionally, we identified several genetic regions associated with an increased risk for both conditions, indicating that they share similar biological pathways and mechanisms.”
The study found that shared genetic risk factors for these diseases are significantly enriched in certain cellular pathways, including epigenetic mechanisms, autoimmune pathways, and cellular signaling, which provides important clues about the underlying mechanisms of these conditions and may help researchers in developing new treatments.
Md Rafiqul Islam, PhD student
Sarah-Nicole Bostan, PhD, the director of Behavior Change Strategy at Signos who was not involved in this research, helped to explain the background of this research topic to Medical News Today.
“Migraine and headaches are two of the most common types of pain-related issues most likely to be reported to non-physician healthcare providers,” she said.
“They often lead to unnecessary medical visits and associated healthcare costs,” Bostan added.
Migraine and headaches are unusual in the sense that they are disorders of exclusion, meaning that diagnoses are arrived at by ruling out serious pathology, which is an inverse process compared to other health conditions. This often leaves patients feeling frustrated and confused about what actionable steps they can take to manage their pain and wondering what might be the root cause.
Sarah-Nicole Bostan, PhD
Bostan explained that in the field of applied psychophysiology and biofeedback, headaches are usually caused by tight muscles, while migraine is often caused by problems with blood flow.
Knowing the difference between these two types of pain can help people treat their symptoms by learning relaxation techniques such as heart rate variability biofeedback, muscle tension biofeedback, making changes to their diet, and taking time to rest or exercise during a migraine.
“This research provides a glimpse of how metabolic and cardiorespiratory factors may be working in tandem even at the genetic level, and how there may be shared genetic etiology of headaches and migraines,” Bostan noted.
Potential implications for people with migraine, headaches
Islam explained how researchers “found shared genes, genetic variants, and pathways associated with an increased risk of migraine and blood sugar imbalance.”
“With this information, researchers can make new screening tests to find people at high risk for developing migraine and blood sugar-related diseases (e.g., diabetes) even before they show symptoms, which can facilitate earlier diagnosis and treatment, thereby improving patient outcomes,” Islam said.
Eventually, this can also lead to better health outcomes for the general population and lower healthcare costs associated with treating diseases like migraine. Furthermore, targeting identified shared pathways (e.g., epigenetic mechanisms, autoimmune pathways, and cellular signaling) may be an effective strategy for developing new treatments for these diseases.
Md Rafiqul Islam, PhD Student
Nancy Mitchell, RN, a registered nurse and contributing writer at the Assisted Living Center, agreed.
“These results could provide a breakthrough in treatment avenues for migraine headaches in particular,” she told Medical News Today.
Bostan pointed out that “although this research found inconsistent evidence regarding impact of glycemic traits on headaches/migraine and noted that their findings were only “nominally significant,” it opens a door to further studying the specific glycemic traits that may be ripe for changing to influence pain pathology.”
“Specifically, the finding that hypoglycemia may be a migraine or headache trigger is consistent with what our members at Signos have anecdotally reported,” she said.
Many have noted they don’t realize their blood sugar may be dipping quickly before experiencing the onset of migraine or headache pain, and once they stabilize their blood sugar through eating a nutritionally balanced meal, people may be able to ameliorate some of this pain if they intervene early enough.
Sarah-Nicole Bostan, PhD
“Previously, behavioral treatments for migraine and headache have focused on relaxation training, cognitive reappraisal of a difficult situation, and nodded to food choices and exercise,” she added.
Bostan concluded that “the takeaway here is that our metabolic stability can influence pain, and therefore, use of metabolically-targeted interventions may be even more important than previously known.”
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