Diabetes linked to risk for Parkinson’s disease: people with type 2 diabetes may have an increased risk of having a diagnosis of Parkinson’s later in life, according to a large study. In addition, the risk may be higher for younger people and those with complications from the disease.
While the association between diabetes and Parkinson’s disease is known, this study adds to our understanding of who is most at risk.
New research suggests that those with T2DM can face a significantly higher risk of developing Parkinson’s disease later in life. Parkinson’s is a progressive disease that affects a part of the brain that helps control movement. In type 2 diabetes, a person either doesn’t make enough insulin to effectively turn glucose into energy or the cells don’t use the insulin as well as they should.
This result comes from the finding of a link after tracking Parkinson’s diagnoses among millions of patients with and without diabetes. Having diabetes can affect the immune system and increase the risk for other diseases.
The study author, Dr. Thomas Warner, said that after accounting for conditions that might mimic Parkinson’s, the research showed that those with type 2 diabetes had a 32% greater risk of later developing the progressively debilitating neurological disorder.
Escalated risk was even more dramatic among younger diabetes patients, ages 25 to 44, who were found to face a fourfold greater likelihood of eventually developing Parkinson’s, according to the report.
Adults with diabetes who had already developed diabetes-related health complications — including damage to the retina, kidneys, or nerves — faced a 49% hike in their Parkinson’s risk.
Although the study could not prove a cause-and-effect relationship, Warner cited two possible reasons for a link between the two diseases.
First, he said, there could be “shared genetic predisposition to develop [both] type 2 diabetes and Parkinson’s.” And then “there may be shared pathways in leading to development of diabetes and Parkinson’s.” While the exact nature of such a connection remains unclear, Warner suggested it might involve the insulin production and glucose control problems that characterize diabetes.
For their study, the investigators used data to identify 2 million British patients newly diagnosed with diabetes from 1999 through 2011. This group was then compared with 6 million British patients who had initially sought care during the same time frame for non-diabetes related issues, such as sprains, varicose veins, appendectomies, or hip replacements.
The researchers found that just over 14,000 of the 2 million patients in the diabetes group were later diagnosed with Parkinson’s, compared with about 21,000 of the 6 million others. That translated into a more than 30% greater risk for Parkinson’s among those with diabetes, the researchers said.
Among patients with diabetes 25 to 44 years old, 58 of over 130,700 people developed Parkinson’s, compared with 280 out of nearly 2.6 million similarly aged people without diabetes. That translated into a fourfold greater Parkinson’s risk among those with diabetes, the researchers said.
“Unlike most tissues in the body, brain cells are almost totally reliant on glucose as a source of energy,” Warner noted. “So if there is a problem in how insulin controls the use of glucose by cells, this may affect certain groups of brain cells selectively.”
Restoring the brain’s ability to use insulin could potentially have a protective effect on the brain,” said Warner. “It is possible that a link between type 2 diabetes and Parkinson’s could affect future diagnosis and treatment of these diseases. Whether it is genetics that may play a role in the development of these diseases or they have similar pathways to development needs to be investigated further.”
Warner is a professor of clinical neurology with the University College London Institute of Neurology, as well as the Queen Square Brain Bank for Neurological Disorder, both in London.
he study authors didn’t examine how diabetes may contribute to Parkinson’s, but prior research does offer clues. We know that neurons consume much more energy than other cells in our bodies. Mitochondria, the powerhouses of our cells, convert glucose into useable energy for cells. In Parkinson’s and other neurodegenerative diseases, mitochondria can become dysfunctional, which may damage and eventually kill neurons. Dopaminergic neurons — the type involved in Parkinson’s — are particularly vulnerable to mitochondrial dysfunction. Diabetes appears to contribute to this, as can some genetic factors.
Practice Pearls:
- The findings may reflect shared genetic predisposition and/or disrupted shared pathogenic pathways with potential clinical and therapeutic implications.
- Patients with type 2 diabetes have a 31% greater risk of developing Parkinson’s than people without diabetes.
- For T2DM patients who are experiencing complications from their diabetes, the risk for Parkinson’s raises to 49% greater risk and 400% for younger people (ages 25-44) with T2DM.
Online issue of Neurology®. June 13, 2018
http://www.diabetesincontrol.com/diabetes-linked-to-risk-for-parkinsons-disease/
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