What is the relationship between multiple sclerosis (MS) and glucose metabolism?

From the Guidelines

Multiple sclerosis (MS) patients should prioritize a diet low in refined sugars and simple carbohydrates to maintain stable blood glucose levels, as this may help manage symptoms and potentially slow disease progression, as suggested by the most recent evidence 1. When considering the relationship between glucose metabolism and MS, it's essential to focus on the most recent and highest quality studies. The 2022 study on dietary recommendations for prevention of atherosclerosis 1 provides valuable insights into the impact of carbohydrate digestion and absorption on post-prandial glucose response. This study suggests that consuming high GI refined cereals can increase the risk of atherosclerosis, which may have implications for MS patients. Some key points to consider:

• MS patients should aim for a diet rich in complex carbohydrates, lean proteins, healthy fats, and plenty of fruits and vegetables to help manage symptoms and potentially slow disease progression.
• Insulin resistance and hyperglycemia may worsen inflammation and neurodegeneration in MS, potentially exacerbating symptoms and disease progression, as noted in the 2022 study on cognitive impairment and type 2 diabetes mellitus 1.
• MS medications like corticosteroids can temporarily raise blood glucose levels during treatment courses, making it essential for MS patients with comorbid diabetes to monitor their glucose levels carefully when on steroid treatments.
• The connection between glucose metabolism and MS involves complex immune system interactions, as elevated glucose levels may promote inflammatory processes that could potentially worsen myelin damage in the central nervous system, highlighting the importance of maintaining stable blood glucose levels through a balanced diet.

From the Research

Multiple Sclerosis and Glucose

• The relationship between multiple sclerosis (MS) and glucose is an area of ongoing research, with studies investigating the impact of dietary interventions on MS symptoms and disease progression 2, 3, 4, 5, 6.
• A 2022 review published in Nutrients highlights the potential role of diet in influencing MS onset, course, and quality of life, although large prospective clinical studies are needed to fully evaluate this relationship 2.
• A 2025 study published in Nutrients found that a multimodal lifestyle intervention, including a modified Paleolithic diet, exercise, and stress reduction, did not negatively impact glycemic and lipid profiles in people with progressive MS, but improvements in serum biomarkers were not statistically significant 3.
• Another study published in 2022 in Physical medicine and rehabilitation clinics of North America notes that various dietary approaches, including low saturated fat, low fat vegan, modified Paleolithic, and Mediterranean diets, have been associated with reduced MS-related symptoms such as fatigue and improved quality of life 4.
• A 2018 review published in Nutritional neuroscience emphasizes the importance of nutritional counseling in MS management, highlighting the need for a multidisciplinary approach to the disease 5.
• A 2023 systematic review published in Nutritional neuroscience evaluated the effects of different dietary interventions in MS patients and found that the Mediterranean diet may be a recommendable option due to its positive health outcomes and lack of side effects, although more studies are needed to reach a definitive conclusion 6.