title: Multicentre analysis of 178,992 type 2 diabetes patients revealed better metabolic control despite higher rates of hypertension, stroke, dementia and repeated inpatient care in patients with comorbid Parkinson's disease.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, 89081 Ulm, Germany. nicole.scheuing@uni-ulm.de
authors.forename: Nicole
authors.initials: N
authors.lastname: Scheuing
authors.forename: Frank
authors.initials: F
authors.lastname: Best
authors.forename: Albrecht
authors.initials: A
authors.lastname: Dapp
authors.forename: Ines
authors.initials: I
authors.lastname: Dreyhaupt
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Filz
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krakow
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lang
authors.forename: Erhard
authors.initials: E
authors.lastname: Siegel
authors.forename: Andrej
authors.initials: A
authors.lastname: Zeyfang
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D016009:Chi-Square Distribution; D015897:Comorbidity; D003704:Dementia / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human