Objective: The objective of this study was to investigate the relationship between glycated haemoglobin (HbA1c) levels in blood and clinical outcomes (MDS-UPDRS III, MDS-UPDRS IV, and MoCA) in patients who have both Parkinson’s disease (PD) and type 2 diabetes (T2DM) who were taking part in the East London PD project.

Background: Recent evidence suggests a link between PD and T2DM, but the relationship is not yet fully understood.

Method: Twenty-six patients had both PD and T2DM and had recent HbA1c levels recorded. Three patients had HbA1c levels in the normal range (≤ 41 mmol/mol), in six patients the HbA1c was mildly raised (42 – 47 mmol/mol) and in 17 the HbA1c levels were high (≥ 48 mmol/mol). Multiple linear regression was used to assess the relationship between HbA1c levels and clinical outcome scores (MDS-UPDRS III and MoCA), after adjusting for age.

Results: A correlation was observed between blood HbA1c levels and MDS-UPDRS III scores in patients with both PD and T2DM (slope = 1.35, 95% CI 0.78 to 1.92; p<0.001). After adjusting for age, a 1mmol/mol increase in HbA1c was associated with 1.33 point increase in the MDS-UPDRS III (95% CI 0.73 to 1.93; p<0.001). An inverse correlation was also observed between HbA1c levels and MoCA scores (p=0.038), but this association weakened after adjusting for age (p=0.053).

Conclusion: In this pilot study, elevated HbA1c levels were associated with higher MDS-UPDRS part III (motor) scores in patients with both PD and T2DM. Elevated HbA1c levels may also be associated with lower MoCA scores and poorer cognitive function. Further studies will be necessary to confirm these findings and their relevance.

References: [1] Markaki, Ioanna, Theodora Ntetsika, Kimmo Sorjonen, Per Svenningsson, and BioPark Study Group. “Euglycemia Indicates Favorable Motor Outcome in Parkinson’s Disease.” Movement Disorders: Official Journal of the Movement Disorder Society, February 26, 2021. [2] Chohan, H., Senkevich, K., Patel, R.K., Bestwick, J.P., Jacobs, B.M., Bandres Ciga, S., Gan‐Or, Z. and Noyce, A.J. (2021), Type 2 Diabetes as a Determinant of Parkinson’s Disease Risk and Progression. Mov Disord.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hba1c-correlates-with-motor-and-cognitive-outcome-scores-in-patients-with-parkinsons-disease-and-type-2-diabetes/