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The Impact of Type 2 Diabetes in Parkinson's Disease

Title: The Impact of Type 2 Diabetes in Parkinson's Disease
Authors: Athauda, Dilan; Evans, James; Wernick, Anna; Virdi, Gurvir; Choi, Minee L.; Lawton, Michael; Vijiaratnam, Nirosen; Girges, Christine; Ben-Shlomo, Yoav; Ismail, Khalida; Morris, Huw; Grosset, Donald; Foltynie, Thomas; Gandhi, Sonia
Source: Athauda, D, Evans, J, Wernick, A, Virdi, G, Choi, M L, Lawton, M, Vijiaratnam, N, Girges, C, Ben-Shlomo, Y, Ismail, K, Morris, H, Grosset, D, Foltynie, T & Gandhi, S 2022, 'The Impact of Type 2 Diabetes in Parkinson's Disease', Movement Disorders, vol. 37, no. 8, pp. 1612-1623. https://doi.org/10.1002/mds.29122
Publication Year: 2022
Collection: University of Bristol: Bristol Reserach
Subject Terms: cognitive impairment; disease progression; Parkinson's; type 2 diabetes
Description: 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.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/35699244; info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/1983/8b575afa-986d-4c24-9e0f-422b6d4fcafe
DOI: 10.1002/mds.29122
Availability: https://hdl.handle.net/1983/8b575afa-986d-4c24-9e0f-422b6d4fcafe; https://research-information.bris.ac.uk/en/publications/8b575afa-986d-4c24-9e0f-422b6d4fcafe; https://doi.org/10.1002/mds.29122; https://research-information.bris.ac.uk/ws/files/337759730/Movement_Disorders_2022_Athauda_The_Impact_of_Type_2_Diabetes_in_Parkinson_s_Disease.pdf
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.3DC47434
Database: BASE