Session Information
Date: Monday, June 5, 2017
Session Title: Parkinson's Disease: Non-Motor Symptoms
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To investigate the association of type 2 diabetes mellitus (DM) with markers of Parkinson’s pathology in patients with early de novo Parkinson’s disease (PD).
Background: DM is associated with 38% increased risk of developing PD. The mechanisms underlying this association are not fully understood. PD and DM neurodegenerative processes share similar dysregulated pathways. Preclinical data have shown that chronic hyperglycemia is associated with reduced dopaminergic transmission and decreased efficacy by dopamine agonist treatment.DM may promote neurodegenerative mechanisms by increasing tau pathology4 and has been associated with faster cognitive decline in older adults.
Methods: Using the Parkinson’s Progression Markers Initiative database, we performed a case-control study comparing PD patients with DM (PD-DM) to those without DM (PD). The two groups were matched for age, gender, disease duration and years of education. Diagnosis of DM was based on clinical history and confirmed by two consecutive measurement of serum glucose levels >126ml/dl. We investigated for associations and differences in motor and non-motor features, in molecular and structural imaging, and in cerebrospinal fluid (CSF) markers of PD pathology. Subsequently, we performed Cox proportional hazards analysis to investigate whether the presence of DM was predictive for PD progression over a 36-months follow-up period. To assist our conclusions, we also performed in parallel similar comparisons between controls with (C-DM) and without DM (HC).
Results: PD-DM patients had higher motor scores (p<0.01), lower striatal dopamine transporter binding (p<0.05), and higher tau CSF levels (p<0.05) compared to PD patients. C-DM also showed lower striatal dopamine transporter binding (p<0.05), and higher tau (p<0.05) and α-synuclein (p<0.05) CSF levels compared to HCs. DM was a predictor for worse motor progression (Hazard Ratio [HR]=4.521, 95% Confidence Interval [C.I.]=1.468–13.926; p<0.01) and worse cognitive decline (HR=9.314, 95% C.I.=1.164–74.519; p<0.05) in PD patients.
Conclusions: DM presence predisposes towards a PD-like pathology and when present in patients with PD is linked to a more aggressive phenotype.
To cite this abstract in AMA style:
G. Pagano, S. Polychronis, H. Wilson, F. Niccolini, M. Politis. Diabetes Mellitus and Parkinson’s Disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/diabetes-mellitus-and-parkinsons-disease/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/diabetes-mellitus-and-parkinsons-disease/