Type 2 Diabetes May Have Adverse Effect on Parkinson Disease Symptoms, Outcomes

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Patients with both Parkinson disease and type 2 diabetes were more likely to have cardiovascular comorbidities than those with only Parkinson disease.
Patients with both Parkinson disease and type 2 diabetes were more likely to have cardiovascular comorbidities than those with only Parkinson disease.

Type 2 diabetes (T2D) could have an unfavorable effect on disease progression, striatal dopamine loss, brain structural alterations, and cognitive performances in individuals with Parkinson disease (PD), according to a retrospective study published in Parkinsonism & Related Disorders.

Researchers retrospectively reviewed 671 individuals from the Yonsei Parkinson Center database and separated these individuals into 2 groups: PD group with T2D (combination group) (n = 106) and PD group without T2D (n = 565).

The average patient age age and age at PD symptom onset were higher in the combination group compared with the PD-alone group. The combination group also had an increased prevalence of hypertension, at 60%, compared with 38% in the PD-alone group. Additionally, the prevalence of cardiac disease was 17% in the combination group, compared with 9% in the PD-alone group, and dyslipidemia was also higher in the combination group, at 16%, compared with 11% in the PD-alone group.

Compared with the PD-alone group, the combination group had severely decreased dopamine active transporter (DAT) availability in the caudate (combination group, 1.74 vs PD-alone group, 1.94; P =.006) and ventral striatum (combination group, 1.94 vs PD-alone group, 2.13; P =.006), with comparable DAT availability in the anterior putamen (P =.536) and posterior putamen (P =.779). The combination group showed inferior cognitive performance in attention, working memory, and frontal executive function domain compared with those in the PD-alone group. The combination group also demonstrated lower performances in language and memory function (P =.069). The estimated monthly levodopa equivalent dose changes were 9.54 in the combination group and 7.09 in the PD-alone group.

The researchers concluded that “coexistent [T2D] had a detrimental effect on the clinical prognosis as well as the baseline striatal DAT availability, brain structural change, and level of cognitive performances in patients with PD.”

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Reference

Chung SJ, Jeon S, Yoo HS, et al. Detrimental effect of type 2 diabetes mellitus in a large case series of Parkinson's disease [published online 2018]. Parkinsonism Relat Disord. doi: 10.1016/j.parkreldis.2018.08.023

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