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Volume 14
Issue 12
10.3390/jcm14124221
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Systematic Review

Risk of Diabetes Mellitus in the Myasthenia Gravis: A Systematic Review and Meta-Analysis

by
Vasileios Giannopapas
1,
Maria-Ioanna Stefanou
1,2,3,
Vasiliki Zouvelou
4,
Georgia Papagiannopoulou
1,
Vassiliki Smyrni
1,
Maria Kosmidou
5,
Dimitrios K. Kitsos
1,
Anna Keramida
1,
Stavroula Salakou
1,
Georgios Tsivgoulis
1,
John S. Tzartos
1 and
Sotirios Giannopoulos
1,*
1
Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
2
Department of Neurology & Stroke, Eberhard-Karls University of Tübingen, 72074 Tübingen, Germany
3
Hertie Institute for Clinical Brain Research, Eberhard-Karls University of Tübingen, 72074 Tübingen, Germany
4
First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece
5
Third Department of Internal Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(12), 4221; https://doi.org/10.3390/jcm14124221
Submission received: 1 May 2025 / Revised: 3 June 2025 / Accepted: 12 June 2025 / Published: 13 June 2025
(This article belongs to the Section Immunology)
Versions Notes

Abstract

Background/Objectives:Myasthenia gravis (MG) comprises an autoimmune disorder marked by muscle weakness and fatigue. MG frequently coexists with other autoimmune conditions, such as diabetes mellitus, which may exacerbate the clinical burden of MG and adversely impact overall quality of life. Methods: This systematic review and meta-analysis aimed to assess the prevalence of diabetes in patients with MG. Following PRISMA guidelines, a comprehensive search was conducted in the MEDLINE PubMed, Scopus, and Google Scholar databases. Results: A total of 11 studies comprising 16,825 patients were included. The pooled prevalence of diabetes among MG patients was 15.6% (95% CI [8.4%, 24.7%]; I2 = 99%, p < 0.001). Compared to healthy controls, MG patients had a 1.24-fold increased risk of developing diabetes (95% CI [1.01–1.54], p < 0.001). Meta-regression showed no association between age and diabetes prevalence, although potential publication bias was noted (Egger’s test, p = 0.72). Conclusions: This meta-analysis reveals a higher prevalence of diabetes among MG patients, with an elevated risk compared to healthy individuals. These findings suggest that the association between MG and diabetes may be mediated by corticosteroid use, genetic factors, and reduced physical activity. The main limitations of this study are the lack of reported data regarding the type of diabetes and patients’ demographic and disease characteristics (MG classification severity and duration and type of treatment). Further studies are needed to investigate the underlying causal mechanisms and to elucidate the relationship between MG and diabetes subtypes.
Keywords: myasthenia gravis; diabetes mellitus; autoimmune disorders myasthenia gravis; diabetes mellitus; autoimmune disorders

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MDPI and ACS Style

Giannopapas, V.; Stefanou, M.-I.; Zouvelou, V.; Papagiannopoulou, G.; Smyrni, V.; Kosmidou, M.; Kitsos, D.K.; Keramida, A.; Salakou, S.; Tsivgoulis, G.; et al. Risk of Diabetes Mellitus in the Myasthenia Gravis: A Systematic Review and Meta-Analysis. J. Clin. Med. 2025, 14, 4221. https://doi.org/10.3390/jcm14124221

AMA Style

Giannopapas V, Stefanou M-I, Zouvelou V, Papagiannopoulou G, Smyrni V, Kosmidou M, Kitsos DK, Keramida A, Salakou S, Tsivgoulis G, et al. Risk of Diabetes Mellitus in the Myasthenia Gravis: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2025; 14(12):4221. https://doi.org/10.3390/jcm14124221

Chicago/Turabian Style

Giannopapas, Vasileios, Maria-Ioanna Stefanou, Vasiliki Zouvelou, Georgia Papagiannopoulou, Vassiliki Smyrni, Maria Kosmidou, Dimitrios K. Kitsos, Anna Keramida, Stavroula Salakou, Georgios Tsivgoulis, and et al. 2025. "Risk of Diabetes Mellitus in the Myasthenia Gravis: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 14, no. 12: 4221. https://doi.org/10.3390/jcm14124221

APA Style

Giannopapas, V., Stefanou, M.-I., Zouvelou, V., Papagiannopoulou, G., Smyrni, V., Kosmidou, M., Kitsos, D. K., Keramida, A., Salakou, S., Tsivgoulis, G., Tzartos, J. S., & Giannopoulos, S. (2025). Risk of Diabetes Mellitus in the Myasthenia Gravis: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 14(12), 4221. https://doi.org/10.3390/jcm14124221

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