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ALS disease onset may occur later in patients with pre‐morbid diabetes mellitus
Author(s) -
Jawaid A.,
Salamone A. R.,
Strutt A. M.,
Murthy S. B.,
Wheaton M.,
McDowell E. J.,
Simpson E.,
Appel S. H.,
York M. K.,
Schulz P. E.
Publication year - 2010
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02923.x
Subject(s) - medicine , amyotrophic lateral sclerosis , diabetes mellitus , disease , pathophysiology , type 2 diabetes mellitus , hyperlipidemia , age of onset , neuropsychology , endocrinology , cognition , psychiatry
Background Several metabolic derangements associated with diabetes mellitus type 2 (DM) have been associated with a better outcome in amyotrophic lateral sclerosis (ALS), including hyperlipidemia and obesity. Here, we tested the hypothesis that DM would have a positive effect on the motor and cognitive findings of ALS. Methods: We compared data from ALS patients with pre‐morbid DM (ALS‐DM; n = 175) versus without DM (ALS; n = 2196) with regard to the age of onset, rate of motor progression, survival, and neuropsychological test performance. Results: The age of onset was later for women, Caucasians and patients with bulbar‐onset ALS. However, we also found that after adjusting for gender, ethnicity and site of onset, DM was associated with a 4‐year later onset of ALS (ALS = 56.3, ALS‐DM = 60.3, P < 0.05). Conclusion: Diabetes mellitus type 2 may delay the onset of motor symptoms in ALS. These findings support other studies suggesting a relationship between the pathophysiology of ALS and metabolic derangements. Further investigations are needed to ascertain whether manipulating metabolic parameters would improve outcomes in ALS.