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Are Diabetes And Parkinson’s Related



Have You Come Across Advice That Those With Parkinsons Should Avoid Too Much Refined Sugar Or Perhaps Youre Aware Of New Research Linking Diabetes And The Condition We Go Behind The Headlines To Find Out What Is Actually Going On

diabetes_parkinsons

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Over the last decade, a war on sugar has started. In March 2016 the government announced that a tax on sugary soft drinks would be introduced in the UK from 2018. At the same time, we’ve seen a gradual increase in messaging that healthy eating, particularly limiting your intake of sugar, is essential for a healthy body.

The main aim of this war is to curb a growing obesity pandemic. And while it’s too early to draw any conclusions about these initiatives on the patterns of obesity in the UK, studies have suggested that simply reducing the sugar content of sweetened beverages by 40% over five years could result in roughly half a million fewer obese adults. As our collective national waistline shrinks, the hope is we will also see a reduction in a range of health conditions from heart problems to cancer, diabetes to osteoarthritis.

Analysis Of The Relationship Between Type Ii Diabetes Mellitus And Parkinsons Disease: A Systematic Review Fauze Camargo Maluf

1Medical Student of Centro Universitario Saude ABC, Centro Universitario Saude ABC, FMABC, Santo Andre 09060-870, Brazil

2Department of Pharmacology, Centro Universitario Saude ABC, FMABC, Santo Andre 09060-870, Brazil

3Department of Neurosciences, Centro Universitario Saude ABC, FMABC, Santo Andre 09060-870, Brazil

Abstract

1. Introduction

The prevalence of type 2 diabetes mellitus is 370 million people in the world. The T2DM is most frequent in adulthood; however, in the last years, the prevalence of T2DM is increasing in adolescents and children . T2DM is a chronic metabolic disease characterized by long-term insulin resistance and a decrease of ?-cell function and population. These factors impair insulin release and consequently cause hyperglycemia . However, genetic and environmental factors are responsible for 20% of ?-cell failure in the diabetic population .

One of the consequences of chronic diabetes is the production of toxic aggregates of the islet amyloid polypeptide . The IAPP might contribute to ?-cell dysfunction .

Parkinson’s disease affects about 1% of people over 65 and up to 4-5% of people over 85, and thus it represents the second most common neurodegenerative disorder .

The diagnosis of PD is still based on the presence of symptoms and clinical signs such as typical asymmetric manifestation, the most common finding being tremor at rest in the upper limbs associated with bradykinesia, rigidity, and gait difficulty .

3. Results

 

    

Diabetes A Contemporary Risk For Parkinsons Disease: Epidemiological And Cellular Evidences

  • 1Nutrition and Health Substantiation Group, Nutrition and Health Program, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation , Adelaide, SA, Australia
  • 2Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
  • 3Cellular Neurobiology, Department of Medical Biology, Université du Québec, Trois-Rivières, QC, Canada
  • 4Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
  • 5National Institute for Neuroscience , University of Cagliari, Cagliari, Italy
  • 6Department of Psychiatry and Neuroscience, Université Laval and CHU Research Center, Québec, QC, Canada

Convincing Evidence That Type 2 Diabetes Is Associated With Increased Risk Of Parkinson’s

Date:
Queen Mary University of London
Summary:
Research has concluded that there is convincing evidence that type 2 diabetes is associated with an increased risk of Parkinson’s disease. The same study found that there was also evidence that type 2 diabetes may contribute to faster disease progression in patients who already have Parkinson’s.

Research from Queen Mary University of London has concluded that there is convincing evidence that type 2 diabetes is associated with an increased risk of Parkinson’s disease. The same study found that there was also evidence that type 2 diabetes may contribute to faster disease progression in patients who already have Parkinson’s.

Treating people with drugs already available for type 2 diabetes may reduce the risk and slow the progression of Parkinson’s. Screening for and early treatment of type 2 diabetes in patients with Parkinson’s may be advisable.

Previous systematic reviews and meta-analyses have produced conflicting results around the link between diabetes and the risk of Parkinson’s disease. This new study, published in the Movement Disorders Journal, used meta-analysis of observational data and meta-analysis of genetic data to evaluate the effect of type 2 diabetes on risk and progression of Parkinson’s disease.

Story Source:

Microglial Activation And Systemic Chronic Inflammation Increase The Risk Of T2dm And Pd

Parkinson

Microglia are mononuclear, phagocytic immune cells in the central nervous system. They are normally involved in removal of damaged neurons, and they release neuroprotective factors to promote synaptic regeneration . Microglia can be activated towards either an anti-inflammatory or inflammatory phenotype. For example, microglia can be stimulated by lipopolysaccharide to enter an activated inflammatory state and express pro-inflammatory cytokines such as TNF?, interleukin 1? and IL6, triggering neuroinflammation . A study of 14 patients with PD found evidence of increased microglial activation on PET imaging . Microglial activation is a key contributor to neuroinflammation through the release of inflammatory cytokines , and patients with PD have been shown to have high concentrations of inflammatory mediators such as IL1?, IL6 and TNF? in the brain .

What Should I Do If Im Managing Type 2 Diabetes And Concerned About My Parkinsons Risk

The takeaway of the new analysis for people currently managing or caring for a person with diabetes is unclear. This specific research, for example, doesn’t illustrate how someone with diabetes may help lower their risk of Parkinson’s disease, says Dr. Cereda.

“Unfortunately, although there is some evidence that diabetes is a risk factor for developing Parkinson’s disease, there is no evidence that optimal diabetes control reduces the risk of Parkinson’s disease,” says Cereda.

Yet managing blood sugar is still essential for people with type 2 diabetes, because failing to do this increases the risk of a wide range of health problems including heart disease, stroke, and kidney failure, Cereda says. The study results suggest that we might one day add Parkinson’s disease to the long list of conditions that can be prevented at least in part by good diabetes management, Cereda adds.

Noyce agrees, emphasizing the importance of blood sugar management regardless of potential Parkinson’s risk. “There are many other negative health outcomes that are associated with type 2 diabetes, such as heart disease, stroke, nerve and kidney damage, and visual loss,” Noyce says. “These are all more common than Parkinson’s, and the risk of these things can be reduced with treatment of diabetes, modification of diet, exercise and self-care.”

Involvement Of Oxidative Stress/mitochondrial Dysfunction In T2dm And Pd Pathogenesis

Mitochondrial proteins, when dysfunctional, produce an increase in oxidative stress and cell death . MPTP exerts its Parkinson’s-like effects in rodent models by selectively inhibiting complex I, the first enzyme in the mitochondrial respiratory chain pathway, leading to neuronal death and neurodegeneration . The features of mitochondrial dysfunction may be shared in T2DM and PD . In PD, dysfunctional insulin signalling has been found to increase oxidative stress , while a recent study showed that chronic insulin resistance in diabetic db/ db mice can cause mitochondrial disruption and dopaminergic neuronal degeneration . Studies using rodent models show that IRS1 and IRS2 inhibit FOXO1 via the PI3K/Akt pathway , resulting in dysfunctional ATP generation and fatty acid oxidation, and the generation of ROS and oxidative stress. While the exact mechanism by which mitochondrial dysfunction and oxidative stress contribute towards PD remains uncertain, its role is likely to be important in PD pathogenesis and potentially relevant to the link with T2DM.

Parkinsons Cancer And Type 2 Diabetes Share A Key Element That Drives Disease CancerCell BiologyDiabetesGeneticsMolecular BiologyParkinson’s DiseaseSalk Institute

Parkin protein is in a different part of the cell than the mitochondria at time 0 but then co-localizes with the mitochondria after 60 minutes . Credit: Salk Institute

Enzyme with central role in cancer and type 2 diabetes also activates “clean-up” protein in Parkinson’s.

When cells are stressed, chemical alarms go off, setting in motion a flurry of activity that protects the cell’s most important players. During the rush, a protein called Parkin hurries to protect the mitochondria, the power stations that generate energy for the cell. Now Salk researchers have discovered a direct link between a master sensor of cell stress and Parkin itself. The same pathway is also tied to type 2 diabetes and cancer, which could open a new avenue for treating all three diseases.

“Our findings represent the earliest step in Parkin’s alarm response that anyone’s ever found by a long shot. All the other known biochemical events happen at one hour; we’ve now found something that happens within five minutes,” says Professor Reuben Shaw, director of the NCI-designated Salk Cancer Center and senior author of the new work, detailed in Science Advances on April 7, 2021. “Decoding this major step in the way cells dispose of defective mitochondria has implications for a number of diseases.”

Study Examines Connection Between Diabetes Medication And Parkinsons Disease

10 early warning signs of Parkinson

It was first suggested in the 1960’s that people with type-2 diabetes are at increased risk for developing Parkinson’s disease – and when they do develop PD, its progression is faster and often more severe. This may be due, in part, to an apparent relationship in the brain between dopamine, insulin resistance, and glucose control. Insulin is not only made in the pancreas, it’s also present in the brain – where it has been shown to impact dopamine levels.

Parkinson’s is generally believed by scientists to be caused by the loss of dopamine-producing neurons. Parkinson’s symptoms, such as slowness, rigidity, and tremor, typically develop after approximately 40-80% of these dopamine-producing neurons die.

Why does this matter? Currently, more than 30 million people in the United States have type-2 diabetes, and that number is growing. The lifetime risk of developing Parkinson’s is also on the rise. In light of these trends, it would be valuable to know whether any specific type-2 diabetes medications might be associated with an increased or decreased risk for developing PD.

1) Thiazolidinediones , like pioglitazone or rosiglitazone , which specifically target insulin resistance

2) Drugs, like albiglutide or dulaglutide , that mimick glucagon-like peptide-1 a hormone that promotes insulin secretion, and

3) Dipeptidyl peptidase 4 inhibitors, which increase GLP-1 levels, and lead to insulin secretion and lowering of blood sugar levels

Results

What Does This Mean?

Learn More

Earlier Research On The Link Between Type 2 Diabetes And Parkinsons Disease

Some previous research has linked certain medications for type 2 diabetes to a lower risk of the development or progression of Parkinson’s disease.

A found Parkinson’s disease symptoms improved in participants who took exenatide, a diabetes drug in a family of medicines known as GLP1 agonists, and worsened when subjects took a placebo. Another , found that individuals with type 2 diabetes who took GLP1 agonists or another type of diabetes drugs known as DPP4 inhibitors had a lower risk of developing Parkinson’s disease.

Slightly elevated blood sugar or variations in blood sugar may contribute to the risk of Parkinson’s disease even in people without diabetes, according to a .

Age is the biggest risk factor for Parkinson’s disease, though, and genetics also account for up to 20 percent of the risk, Foltynie says.

RELATED: How to Keep Your Brain Healthy: A Conversation With Sanjay Gupta, MD

Common Diabetes Drugs May Help Prevent Parkinsons Disease Large Study Finds

Ruth Brauer. Ian Wong, Tom Foltynie et al. Diabetes medications and risk of Parkinson’s disease: a cohort study of patients with diabetes, Brain . DOI: 10.1093/brain/awaa262This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

Links Between Insulin Resistance Metabolic Syndrome And Parkinsons Disease

Insulin resistance and metabolic syndrome are very common in the United States, but are also noted to have increased incidence in patients with Parkinson’s disease . Insulin resistance may precede the development of diabetes by many years, but with treatment, diabetes can be avoided.

Growing evidence now shows an association of insulin resistance and metabolic syndrome with worse symptoms and progression of Parkinson’s disease . Lima et al. have shown diabetes incidence in PD is associated with faster progression of both motor and cognitive symptoms.

Type 2 Diabetes Related With Higher Risk Of Parkinsons Disease Finds Study

Diabetes and Risk of Parkinson’s Disease

As per the latest research from Queen Mary University of London, a convincing evidence highlighting the association of type 2 diabetes with a higher risk of Parkinson’s Disease has been found. Published in the Movement Disorders Journal, the study also found that type 2 diabetes may contribute to quick disease progression in Parkinson’s patients.

It must be noted that the study was conducted by researchers to evaluate and investigate type 2 diabetes by performing meta-analysis of observational and genetic summary data. In the past, meta-analysis and systematic reviews have given conflicting results with regards to the relation between diabetes and the risk of Parkinson’s Disease. The new, recent study is expected to provide optimum results. 

Must Read: 

Parkinson Disease Symptoms, Causes And Treatment

According to Dr. Alastair Noyce, Corresponding Author, Queen Mary University of London, the current research provides results from multiple studies to give evidence that type 2 diabetes not only affects the risk of Parkinson’s Disease, but also promotes its progression. He also emphasises that there are many treatment strategies for type 2 diabetes that may be repurposed for the treatment of Parkinson’s Disease.

With this study, experts conclude that even if a diabetic person doesn’t have Parkinson’s Disease, they must keep their blood glucose levels within the normal range to ensure proper brain health. 

How to Claim the Diabetes Cover in Health Insurance

Is Telehealth Available If I Don’t Feel Comfortable Going Into The Office

This is a question best answered by your Parkinson’s disease care team, but for many people, telehealth visits are now available. Though some visits may best be done in person, telehealth offers many benefits and may be an appropriate choice for visits such as those needed for medication refills. 

How to Use Telehealth Virtual Visits During the COVID-19 Outbreak

Is It Okay To Take Cough Or Cold Medications If I Am Diagnosed With Covid

It is always important to discuss with your Parkinson’s disease provider or pharmacist any prescription or over-the-counter medications you plan to take. Some medications for Parkinson’s disease have interactions with other medications, such as over-the-counter cough and cold medications, and should be avoided.

The Association Between Type 2 Diabetes Mellitus And Parkinsons Disease

Article type: Review Article

Affiliations: Barts and The London School of Medicine, Queen Mary University of London, London, UK | Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, London, UK | Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, UK | Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK

Correspondence: Correspondence to: Alastair J. Noyce, MRCP, PhD, Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK. Tel.: +44 207 882 5841; E-mail: .

Keywords: Parkinson’s disease, type 2 diabetes mellitus, epidemiology, therapeutics, mechanisms

DOI: 10.3233/JPD-191900

Journal: Journal of Parkinson’s Disease, vol. 10, no. 3, pp. 775-789, 2020

Abstract

Insulin Dysregulation May Be Involved In Pathophysiology Of Pd And T2dm

Diabetes and Parkinson’s – The Science of Parkinson

Insulin receptors are expressed in the basal ganglia and in the substantia nigra , which are the areas of the brain most affected in patients with PD. Studies using rodent models have shown that insulin resistance may cause reduced expression of surface dopamine transporters in the striatum , reduced dopamine turnover , and reduced insulin-dependent dopamine release in the striatum . 1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine is a toxin that induces parkinsonism by producing oxidative stress in dopaminergic neurons, resulting in mitochondrial dysfunction and cell death, and MPTP treated rodents are one of the most commonly used animal models for PD . MPTP-treated mice have been observed to have simultaneous increases in pancreatic and midbrain expression of pro-inflammatory cytokines and ?-synuclein, hinting at potential organ-specific links between PD and T2DM .

A Common Type 2 Diabetes Drug Could Be Slowing The Onset Of Parkinson’s DAVID NIELD

Medication used to treat diabetes could reduce the risk of developing Parkinson’s disease, according to new research, opening up a range of potential options for treating and managing the degenerative brain disorder.

Looking at patient records for 100,288 individuals with type 2 diabetes, scientists found that while these individuals had a higher than normal risk of developing Parkinson’s, commonly prescribed diabetes drugs also seemed to lower that risk.

Those who were taking two particular types of diabetes drugs – GLP-1 receptor agonists and DPP4 inhibitors – were less likely to be diagnosed with Parkinson’s later in life than those on other treatments. In the case of GLP-1 receptor agonists, the likelihood dropped by 60 percent.

“Our study has strengthened evidence that there is a link between type 2 diabetes and Parkinson’s disease, although it remains clear that most people with diabetes will not go on to develop Parkinson’s,” says neuroscientist Tom Foltynie, from University College London in the UK.

The research follows up a 2018 study that covered some 2 million individuals with type 2 diabetes, showing that while the chances of developing Parkinson’s remained low, having diabetes increased that chance by around a third – though as yet it’s not clear exactly why.

The research has been published in Brain.

Parkinsons Disease And The Vulnerability Of The Nigrostriatal Pathway

PD is the prototype of movement disorders. In fact, the most prominent feature of PD is the presence of motor symptoms expressed in a majority of patients as a classical triad of resting tremor, bradykinesia, and rigidity . Non-dopaminergic motor features may also arise and result in falls, freezing of gait, speech impairment and difficulty in swallowing. Accompanying motor symptoms are equally disabling non-motor manifestations, such as psychiatric disturbances, dementia and autonomic failure .

The neuropathological hallmark of PD is the progressive and relentless degeneration of dopaminergic neurons located in the substantia nigra pars compacta. Idiopathic PD still composes approximately 90–95% of diagnoses that are not always faithfully represented by genetic forms in terms of symptomatology and pathophysiology .

Despite their apparent disparity, multiple mechanisms converge to cause the degeneration of nigrostriatal neurons and possibly contribute to oxidative stress to which these neurons may be more vulnerable . This concept dates back to the 1980s , but its popularity has waxed and waned at the rhythm of discoveries; nevertheless, the idea that metabolic oxidative insults may underlie the specific vulnerability of nigrostriatal neurons has lately gained momentum .

6. Last, they are endowed with a limited calcium-buffering capacity and scanty endogenous antioxidative defenses , consequent of their low expression of calbindin and glutathione , respectively.

Common Pathogenic Mechanisms Of Systemic And Brain Insulin Resistance

As epidemiological evidence for a link between PD and T2DM accumulates, parallel experimental evidence indicates potential overlap in disease mechanisms and pathways. Systemic insulin resistance has long been an established key feature of T2DM. Recently, studies have found that insulin resistance is present in the brain in neurodegenerative diseases such as Alzheimer’s disease and other dementias , and PD . Both systemic and local insulin resistance may drive pathology in the brain. Systemic insulin resistance may do so through hyperglycaemia and its consequences , microvascular disease, chronic inflammation, and dysfunction of the blood brain barrier, which may be compounded by associated comorbidities such as hypertension, dyslipidaemia and renal impairment . Local brain insulin resistance may act via protein deposition and aggregation, and failure of clearance mechanisms, independent of systemic insulin resistance .

How Type 2 Diabetes May Contribute To The Risk Of Parkinsons Disease

Diabetes and Parkinson’s – The Science of Parkinson

Although the analysis wasn’t designed to determine how type 2 diabetes might cause Parkinson’s disease to develop or progress, it’s possible that systemic inflammation present with type 2 diabetes may contribute to Parkinson’s disease, says Noyce.

Vascular disease that develops with type 2 diabetes may also lead to impaired blood flow to the brain that hastens the development of Parkinson’s disease, hypothesizes Emanuele Cereda, MD, PhD, of the clinical nutrition and dietetics unit at Fondazione IRCCS Policlinico San Matteo in Pavia, Italy, who was not involved in the current study.

Another possibility is that the same processes that cause diabetes also cause the nerve cell degeneration present in Parkinson’s disease, says Tom Foltynie, PhD, a professor of neurology at University College London in the United Kingdom.

In particular, insulin resistance, the body’s inability to respond normally to the hormone insulin, may be involved in both type 2 diabetes and Parkinson’s disease, says Dr. Foltynie, who also was not involved in the current research.

RELATED: Why Some Researchers Are Calling Alzheimer’s a ‘Type 3 Diabetes’

Epidemiological Evidence: Parkinsons Disease In Diabetic Patients

The first indications of a possible association between DM and PD date back to almost 60 years ago. Studies conducted in parallel showed that DM exacerbates the progression of motor and cognitive deficits in PD , and that non-diabetic parkinsonian patients present impaired glucose tolerance and hyperglycemia . Since then, these findings have been reiterated in parkinsonian patients medicated with dopamine-replacing therapy , but also in drug-naïve parkinsonian patients who still displayed higher-than-normal levels of fasting blood glucose, within the prediabetic diagnostic range . In addition, dietary habits featuring an elevated intake of high glycemic indexed carbohydrates have more recently been associated with greater odds of developing PD .

Despite the recent medical advances in teasing out the cause-effect relationship linking DM and PD, it is still unclear which of the multifarious metabolic changes that occur in DM trigger the nigrostriatal degeneration underlying PD. The two predominant lines of thought grant importance to the dimensions of defective insulin signaling and oxidative stress.

Rerouting Mechanisms: Polyol Pathway And Macromolecules Glycation

Aside from ROS generated through mitochondrial failure, hyperglycemia may trigger the onset of oxidative stress via pathways that dwell upstream the glycolytic enzyme GAPDH .

As previously discussed, free glucose is present in the cytosol of neurons and its concentrations rise during hyperglycemia leading to glucotoxicity. Under normal circumstances, hexokinase is mandated to transform available glucose into glucose 6-phosphate. However, due to substrate-mediated inhibition, in hyperglycemic conditions, it can only funnel a fraction of cytosolic glucose toward the glycolytic pathway before becoming saturated. Excess glucose is therefore consumed by other pathways and is constantly replenished by high extracellular levels. The principal compensatory outlets are the polyol pathway and macromolecule glycation which are two key pathways through which glucotoxicity manifests .

AGEs may also occur extracellularly or being directly secreted from the cells in which they are generated to induce oxidative stress and inflammation in a variety of cells . AGEs trigger oxidative stress by binding their cognate membrane receptor, the RAGE and activating downstream mediators know to induce oxidative stress, such as the inducible nitric oxide synthase . Nevertheless, despite AGEs being described for their ability to promote oxidative stress in peripheral tissues , their role in oxidative stress in PD remains to be elucidated.

Type 2 Diabetes Linked To Increased Risk Of Parkinsons Disease

Genetic data suggests there may be a direct relationship between type 2 diabetes and a higher risk of the movement disorder, as well as its progression, but more studies are needed.

Everyday Health

People managing type 2 diabetes and their doctors may need to have Parkinson’s disease on their radar, as new research sheds light on the possible connection between these two chronic health conditions.

For the review and meta-analysis, which was , researchers examined data combined from nine previous studies that followed individuals with type 2 diabetes over time to see if they developed Parkinson’s disease. They found type 2 diabetes associated with a 21 percent increased risk of Parkinson’s and with faster symptom progression. Parkinson’s causes muscle stiffness, tremors, impaired balance, and slow movement, in addition to cognitive and sleep issues, according to the National Institute on Aging.

Yet study authors could not account for the severity of participants’ type 2 diabetes, and they couldn’t determine the effect of diabetes drugs or quality of blood sugar management on Parkinson’s disease risk — two major limitations.

The research doesn’t prove that diabetes causes Parkinson’s, though researchers speculated the disease may contribute to this risk. They conducted a separate analysis of studies that identified common genetic variations present with the two conditions and found that type 2 diabetes directly increased the odds of developing Parkinson’s by 8 percent.

Cellular Evidence: Neuronal Oxidative Stress In Hyperglycemia

Diabetes and Risk of Parkinson’s Disease

The clinical significance of hyperglycemia emerged upon its formal identification as the prime culprit in comorbid diabetic complications Group, 1998; Gaede et al., 2008; Giacco and Brownlee, 2010). The most affected collateral targets in DM are the kidneys, the cardiovascular system and the nervous system . Despite their many functional and phenotypic differences, the cells of these systems share the distinct liability of taking up glucose in an extracellular concentration-dependent but insulin-independent manner . Indeed, mesangial and endothelial cells predominantly express the insulin-independent glucose transporter GLUT1 ; likewise, brain cells express the insulin-independent GLUTs, GLUT1 and GLUT3 with the latter being particularly abundant in neurons . Although it is clear that glucose concentrations rise in these cells under conditions of hyperglycemia, how exactly glucotoxicity-mediated cellular damage occurs is not as forthright. The current consensus is that oxidative stress may represent the principal mediator of hyperglycemia-induced diabetic complications .

Prevalence Of Cognitive Impairments In Parkinsons Disease

Cognitive deficits are common in PD, but vary in both quality and severity in different stages of the disease. The spectrum ranges from subjective cognitive decline to mild cognitive impairment and PD dementia . Subjective cognitive decline does not have established criteria, but it is generally defined as a mild impairment noted by the patient, family or caregivers, although performance in formal cognitive testing is within normal range. Little is known about the occurrence of subjective cognitive decline in PD, but it is assumed to precede future progression to MCI and dementia . The main difference between PD–MCI and PDD is the degree to which the cognitive decline affects everyday life functioning, which is minimal in the case of PD–MCI but substantial in PDD . The cognitive decline often hides under more profound motor deficits and only detailed neurocognitive evaluation reveals the grade to which these deficits extend . Among patients with PD, 25–30% have PD–MCI , while an additional 30% have a PDD diagnosis . An 8-year cumulative prevalence of 78% for getting a diagnosis of PDD has been reported in a Norwegian cohort and a cumulative incidence of 83% 20 years after initial diagnosis was reported in the Sydney multicentre study of PD .

The Relationship Between Diabetes And Parkinsons Disease

A previous study revealed that the conditions that come together for metabolic syndrome, such as heart disease and diabetes, may very well be risk factors for Parkinson’s disease.

Now, an observational study conducted by Queen Mary University of London found people with type 2 diabetes have a 21 percent higher risk of developing Parkinson’s disease. Results also indicated a possible association between type 2 diabetes and faster progression of motor symptoms and cognitive decline.

The researchers note that since Parkinson’s only affects around 1-2 percent of those over age 60, people with type 2 diabetes still have a very small absolute risk of developing Parkinson’s.

Type 2 Diabetes Linked To Increased Risk For Parkinson’s

Sue Hughes

March 12, 2021

New analyses of both observational and genetic data have provided “convincing evidence” that type 2 diabetes is associated with an increased risk for Parkinson’s disease.

Dr Alastair Noyce

“The fact that we see the same effects in both types of analysis separately makes it more likely that these results are real — that type 2 diabetes really is a driver of Parkinson’s disease risk,” Alastair Noyce, PhD, senior author of the new studies, told Medscape Medical News.

The two analyses are reported in one paper March 8 in the journal Movement Disorders.

Noyce, who is clinical senior lecturer in the preventive neurology unit at the Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK, explained that his group is interested in risk factors for Parkinson’s disease, particularly those relevant at the population level and which might be modifiable.

“Several studies have looked at diabetes as a risk factor for Parkinson’s but very few have focused on type 2 diabetes and, as this is such a growing health issue, we wanted to look at that in more detail,” he said.

The researchers performed two different analyses: a meta-analysis of observational studies investigating an association between type 2 diabetes and Parkinson’s; and a separate Mendelian randomization analysis of genetic data on the two conditions.

Movement Disorders. Published online March 8, 2021. Full text 

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Is There A Link Between Diabetes And Parkinsons Disease

Understanding Parkinson’s Disease Anatomical Chart, 2nd ...

The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

Dr Beckie Port Research Manager At Parkinson’s Uk Said:

“This study is the most robust evidence to date that there is a link between Parkinson’s and type 2 diabetes.

“The vast majority of people with diabetes will not go on to develop Parkinson’s. Studies that demonstrate type 2 diabetes is linked to an increased risk of Parkinson’s suggest, however, that the two conditions may affect cells in similar ways.

“Understanding the link between these two conditions could be key to developing treatments that slow the course of Parkinson’s, something that no current treatments can do.

“Currently, there is much interest in the potential for anti-diabetic drugs, such as exenatide, to slow the progression of Parkinson’s. The ability to repurpose these drugs, which are already used to treat people with diabetes, could speed up the delivery of new and better treatments to people with Parkinson’s who urgently need them.”


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