title: Pre-morbid type 2 diabetes mellitus is not a prognostic factor in amyotrophic lateral sclerosis.
abstract: BACKGROUND
  The aim of this study was to determine whether a history of pre-morbid type 2 diabetes mellitus (DM2) is a prognostic factor in amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  The relationship between DM2 and survival was analyzed in a study population consisting of 1,322 participants from 6 clinical trials.
  
  
  RESULTS
  Survival did not differ by diabetes status (log-rank test, P = 0.98), but did differ by body mass index (BMI) (log-rank test, P = 0.008). In multivariate analysis, there was no significant association between diabetes and survival (P = 0.18), but the risk of reaching a survival endpoint decreased by 4% for each unit increase in baseline BMI (HR 0.96, 95% CI 0.94-0.99, P = 0.001). DM2 was less prevalent among ALS clinical trial participants than predicted.
  
  
  CONCLUSIONS
  A history of pre-morbid DM2 is not an independent prognostic factor in ALS clinical trial databases. The low DM2 prevalence rate should be examined in a large, prospective study to determine whether DM2 affects ALS risk.
authors.affiliation: Neurological Clinical Research Institute, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.|VA Healthcare System, Boston, Massachusetts, USA.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Paganoni
authors.affiliation: Department of Neurology, Washington University School of Medicine, 115 Biotech Building, Box 8111, 660 South Euclid, Street, St. Louis, Missouri, 63110, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Hyman
authors.affiliation: Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Shui
authors.affiliation: Department of Neurology, Washington University School of Medicine, 115 Biotech Building, Box 8111, 660 South Euclid, Street, St. Louis, Missouri, 63110, USA.
authors.forename: Peggy
authors.initials: P
authors.lastname: Allred
authors.affiliation: Department of Neurology, Washington University School of Medicine, 115 Biotech Building, Box 8111, 660 South Euclid, Street, St. Louis, Missouri, 63110, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Harms
authors.affiliation: Department of Neurology, Washington University School of Medicine, 115 Biotech Building, Box 8111, 660 South Euclid, Street, St. Louis, Missouri, 63110, USA.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Maragakis
authors.affiliation: Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schoenfeld
authors.affiliation: Neurological Clinical Research Institute, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.affiliation: Neurological Clinical Research Institute, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Nazem
authors.initials: N
authors.lastname: Atassi
authors.affiliation: Neurological Clinical Research Institute, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Merit
authors.initials: M
authors.lastname: Cudkowicz
authors.affiliation: Department of Neurology, Washington University School of Medicine, 115 Biotech Building, Box 8111, 660 South Euclid, Street, St. Louis, Missouri, 63110, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology / Q000401:mortality*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015996:Survival Rate
keywords: ALS; BMI; diabetes; prognosis; survival