Journal
PARKINSONISM & RELATED DISORDERS
Volume 19, Issue 7, Pages 687-692Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2013.03.011
Keywords
Parkinson's disease; Type 2 diabetes mellitus; Diabetes endpoints; Metabolic control
Categories
Funding
- German Competence Network for Diabetes mellitus
- German Competence Network for Obesity
- Federal Ministry of Education and Research [FKZ: 01GI1106, FKZ: 01GI1130]
- European Foundation for the Study of Diabetes (EFSD)
- Diabetes Research for Patient Stratification consortium (DIRECT)
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Background: Especially in older people, physicians are faced with the coexistence of type 2 diabetes mellitus (T2DM) and Parkinson's disease (PD). Therefore, this research aimed to compare diabetes endpoints between T2DM with and without PD. Methods: Based on the standardized, multicenter, prospective DPV database, 178,992 T2DM patients (>= 40 years) were analyzed. 1579 were diagnosed with PD and/or received specific treatment. Hierarchical multivariable regression models were used for group comparisons; adjusted estimates based on observed marginal frequencies were calculated. Results: PD patients were significantly older (77.9 vs. 70.0 years; p < 0.0001) and had a longer diabetes duration (10.3 vs. 8.4 years; p < 0.0001). In young PD patients (<50 years), percentage of females was significantly higher compared to age-matched T2DM patients without PD or people of the German population (66.7 vs. 38.1 vs. 49.0%; p < 0.0001, p < 0.02). After demographic adjustment, T2DM patients with PD showed a significantly lower HbA1c (58.0 vs. 60.3 mmol/mol; p < 0.0001), OAD/GLP-1 treatment (41.9 vs. 45.9%; p < 0.01) and frequency of dyslipidemia (62.0 vs. 64.5%; p < 0.05). In contrast, rates of insulin therapy (57.8 vs. 54.8%; p < 0.05), hypertension (73.3 vs. 68.6%; p < 0.001), antihypertensive medication (60.4 vs. 56.1%; p < 0.01), stroke (12.0 vs. 7.3%; p < 0.0001), dementia (9.2 vs. 2.6%; p < 0.0001) and repeated inpatient care (15.7 vs. 12.0%; p < 0.0001) were significantly higher and duration of hospital stay (6.2 vs. 4.7 days; p < 0.0001) was significantly longer in T2DM with PD. Conclusion: Clear demographic and clinical differences were observed between T2DM with and without PD. In PD patients, metabolic control is better, potentially due to more intensive medical care. (c) 2013 Elsevier Ltd. All rights reserved.
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