ALS disease onset may occur later in patients with pre-morbid diabetes mellitus.
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).


CONCLUSIONS
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.
Jawaid
A
A
Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
Salamone
A R
AR
Strutt
A M
AM
Murthy
S B
SB
Wheaton
M
M
McDowell
E J
EJ
Simpson
E
E
Appel
S H
SH
York
M K
MK
Schulz
P E
PE
D017668:Age of Onset; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000209:etiology; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015996:Survival Rate