Abstract
Background: Type 2 diabetes (T2DM) is an established risk factor for developing Parkinson's disease (PD), but its effect on disease progression is not well understood.
Objective: The aim of this study was to investigate the influence of T2DM on aspects of disease progression in PD.
Methods: We analyzed data from the Tracking Parkinson's study to examine the effects of comorbid T2DM on PD progression and quality of life by comparing symptom severity scores assessing a range of motor and nonmotor symptoms.
Results: We identified 167 (8.7%) patients with PD and T2DM (PD + T2DM) and 1763 (91.3%) patients with PD without T2DM (PD). After controlling for confounders, patients with T2DM had more severe motor symptoms, as assessed by Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (25.8 [0.9] vs. 22.5 [0.3] P = 0.002), and nonmotor symptoms, as assessed by Non-Motor Symptoms Scale total (38.4 [2.5] vs. 31.8 [0.7] P < 0.001), and were significantly more likely to report loss of independence (odds ratio, 2.08; 95% confidence interval [CI]: 1.34–3.25; P = 0.001) and depression (odds ratio, 1.62; CI: 1.10–2.39; P = 0.015). Furthermore, over time, patients with T2DM had significantly faster motor symptom progression (P = 0.012), developed worse mood symptoms (P = 0.041), and were more likely to develop substantial gait impairment (hazard ratio, 1.55; CI: 1.07–2.23; P = 0.020) and mild cognitive impairment (hazard ratio, 1.7; CI: 1.24–2.51; P = 0.002) compared with the PD group.
Conclusions: In the largest study to date, T2DM is associated with faster disease progression in Parkinson's, highlighting an interaction between these two diseases. Because it is a potentially modifiable metabolic state, with multiple peripheral and central targets for intervention, it may represent a target for alleviating parkinsonian symptoms and slowing progression to disability and dementia.
| Original language | English |
|---|---|
| Pages (from-to) | 1612-1623 |
| Number of pages | 12 |
| Journal | Movement Disorders |
| Volume | 37 |
| Issue number | 8 |
| Early online date | 14 Jun 2022 |
| DOIs | |
| Publication status | Published - 18 Aug 2022 |
Bibliographical note
Funding Information:Tracking Parkinson's is primarily funded and supported by Parkinson's UK. It is also supported by the National Institute for Health Research Dementias and Neurodegenerative Diseases Research Network. This research was supported by the National Institute for Health Research University College London (UCL) Hospitals Biomedical Research Centre. The UCL Movement Disorders Centre is supported by the Edmond J. Safra Philanthropic Foundation.
Funding Information:
D.A. has received honoraria from Bial Pharma and grant funding from CureParkinson's, Parkinson's UK, and National Institute for Health Research, outside of the submitted work. N.V. has received unconditional educational grants from IPSEN and Biogen, travel grants from IPSEN and AbbVie, and honorarium from AbbVie and STADA, and has served on advisory boards for AbbVie and Brittania, outside of the submitted work. Y.B.‐S. has received grant funding from the Medical Research Council, National Institute for Health Research, Parkinson's UK, National Institutes of Health, and Economic and Social Research Council. H.M. reports paid consultancy from Biogen, UCB, AbbVie, Denali, Biohaven, and Lundbeck; lecture fees/honoraria from Biogen, UCB, C4X Discovery, GE‐Healthcare, Wellcome Trust, and Movement Disorders Society; research grants from Parkinson's UK, Cure Parkinson's Trust, PSP Association, CBD Solutions, Drake Foundation, and Medical Research Council. D.G. received honoraria from Bial Pharma, Merz Pharma, and consultancy fees from The GM Clinic, Glasgow. T.F. has received honoraria from Profile Pharma, BIAL, AbbVie, Genus, Medtronic, and St. Jude Medical, outside of the submitted work. All other authors have nothing to report.
Publisher Copyright:
© 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Keywords
- cognitive impairment
- disease progression
- Parkinson's
- type 2 diabetes
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