Abstract
Objectives To review the change in headache frequency of two diabetic patients before and after initiation of insulin therapy, and to generate hypotheses regarding possible mechanisms underlying the potential link between headaches and glucose regulation. Case Report Hyperglycemia and hypoglycemia are both triggers for migraines. We present a series of two cases of women with diabetes who were started on insulin therapy in an attempt to reduce the frequency of their chronic migraine headaches. To our knowledge, this is the first such report in the literature. Both patients had glucose control at goal (A1c <6.5) and otherwise would not have warranted initiation of insulin. One patient had a 90% reduction in migraine frequency. The other had a 50% reduction in migraine frequency, and an 80-90% reduction in cluster headache frequency. Conclusion Fluctuations in glucose levels, rather than changes in insulin levels, are the likely triggers of the headaches seemingly associated with carbohydrate consumption. Judicious use of insulin in carefully selected patients may represent a novel method of preventing migraines.
Highlights
In addition to more classic stimuli, migraines may be triggered by high carbohydrate meals, prolonged fasting, and hypoglycemia
To review the change in headache frequency of two diabetic patients before and after initiation of insulin therapy, and to generate hypotheses regarding possible mechanisms underlying the potential link between headaches and glucose regulation
We present a series of two cases of women with diabetes who were started on insulin therapy in an attempt to reduce the frequency of their chronic migraine headaches
Summary
In addition to more classic stimuli, migraines may be triggered by high carbohydrate meals, prolonged fasting, and hypoglycemia. A ketogenic (low carbohydrate) diet has been shown to reduce literature. Both patients had glucose control at goal (A1c
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