There are two types of diabetes (type 1 and type 2), and both may be more common among people with multiple sclerosis (MS). Life with MS can be complicated when you’re juggling multiple health conditions. As one MyMSTeam member shared, “My biggest issues with my MS are balance, numbness in my right hand, and bladder and bowel issues. I also have diabetes. So, things are a struggle right now.” Fortunately, working with your health care team and making healthy lifestyle choices can help you better manage both conditions.

Here’s what to know about the relationship between MS and diabetes, as well as ways to cope if you’re living with both.

Understanding the Risk of Diabetes in MS

Having type 1 diabetes is considered a risk factor for MS. People who have type 1 diabetes have a three-fold higher risk of developing MS than people who do not have type 1 diabetes.

On the other hand, type 2 diabetes may be a risk among people who already have MS. Researchers are unclear whether disability from MS contributes to type 2 diabetes or whether other factors — such as genetics, lifestyle, or environmental factors — may play a role. One study found that insulin resistance (a primary marker of type 2 diabetes) was 46 percent higher in people with MS compared to those without MS.

Causes and Risk Factors

In both type 1 and type 2 diabetes, the body has trouble regulating sugar levels in the blood. However, the two conditions are not the same. MS can possibly contribute to the development or progression of diabetes in a few ways.

MS and Type 1 Diabetes

Type 1 diabetes has some similarities to MS: They’re both autoimmune disorders. In type 1 diabetes, the immune system attacks cells in the pancreas that produce insulin. Because people with type 1 diabetes can’t produce insulin, they need insulin injections to survive. In the case of MS, the immune system attacks the myelin sheath covering nerve cells in the central nervous system (the brain and spinal cord). This causes nerve damage, which leads to MS symptoms like fatigue, vision problems, and numbness or tingling.

It’s not understood how much type 1 diabetes and MS affect each other, but it’s possible that the immune system response in both diseases is related.

MS and Type 2 Diabetes

In type 2 diabetes, the body becomes resistant to the effects of insulin. People with type 2 diabetes often have high insulin levels, but they can’t use insulin effectively to keep their blood sugar levels in the normal range. Over time, high blood sugar levels damage the circulatory system and organs. They also lead to inflammation and increase the risk of other diseases, such as kidney disease and high blood pressure.

Type 2 diabetes is strongly correlated with lifestyle factors, and certain attributes of MS may make a person more susceptible to type 2 diabetes. For example, if you have MS and are often fatigued or unable to exercise, you may adopt a more sedentary lifestyle. A sedentary lifestyle may increase the risk of type 2 diabetes. The stress sometimes associated with living with MS can also promote inflammation and insulin resistance, which are well-known markers of type 2 diabetes.

Fortunately, people with type 2 diabetes can often make positive changes that help reduce the severity of the disease. People diagnosed early (in the prediabetes stage) can even prevent the disease from progressing to type 2 diabetes with healthy lifestyle changes.

Living With MS and Diabetes

When you have multiple health conditions, it’s not always easy to tell what’s causing your symptoms. If you assume everything is related to MS, you may delay seeing your doctor about new symptoms or getting treatment for a comorbidity (co-existing condition) such as diabetes. That’s why it’s so important to pay attention to any changes in how you feel — and to communicate with your health care provider when you have concerns.

Many steps to get MS under control can also help you manage diabetes. Here are some tips for coping with both conditions.

Stay Active

Be active when you can. Physical activity can help combat brain aging associated with both diabetes and MS. Exercise may also help reduce insulin resistance.

Find Ways To Manage Stress

Stress can raise inflammation levels. Healthy coping strategies like meditation and deep breathing can help you better manage stress.

Focus on High-Fiber Foods

Dietary fiber promotes healthy gut bacteria, which are essential for the immune system and MS. Fiber also helps maintain a healthy body weight and good blood sugar control.

Make Sleep a Priority

Fatigue is a common problem in MS and diabetes. Getting into a regular sleep routine is essential for feeling your best.

Talk to Your Doctor About Intermittent Fasting

There’s also some interesting research to support the benefits of intermittent fasting for MS and diabetes. However, fasting can be dangerous if you take certain medications or are at risk of low blood sugar levels. Ask your doctor before making drastic changes to your diet to determine if short-term fasting would be safe and beneficial for you.

Double-Check Your Medications

Because of the similarities between type 1 diabetes and MS, some treatment approaches overlap. Check in with your health care provider to ensure that you’re prescribed the proper amount of medication.

Some treatments for diabetes and MS suppress the whole body’s immune system, but targeted therapies are being developed that can treat diabetes or MS more specifically. Having more targeted therapies in the future can help address overprescription.

Stay Organized

When managing your health, staying organized is crucial. Having tools like a calendar on your phone or a pocket medication journal can help you keep track of your medications and doctor’s appointments.

It’s also essential that all of your health care providers communicate with each other. Be sure to make your doctors aware of any other providers you’re seeing, and let them know if you start a new medication or experience any side effects.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Do you have MS and diabetes? Which diagnosis did you receive first, and how do you manage both conditions? Share your thoughts in the comments below, or start a conversation by posting on MyMSTeam.