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Blood sugar levels appear to affect motor skills in patients with Parkinson’s disease

Abnormal blood sugar (glucose) levels, below or above the norm, appear to be linked to faster progression of motor difficulties in people with Parkinson’s disease, research suggests.

The brief report on this discovery, “Euglycemia indicates a favorable motor outcome in Parkinson’s disease,»Was published in the journal Movement disorders.

Previous research supports that type 2 diabetes is detrimental to people with Parkinson’s disease. Severe diabetes has been associated with an increased risk of postural instability and poorer gait, as well as more cognitive problems.

However, few studies follow over longer periods of time the evolution of motor and cognitive disorders as a function of a person’s blood sugar. Researchers at the Karolinska Institute in Sweden and their colleagues conducted a retrospective analysis to assess the correlation between these sugar levels and the progression of motor symptoms and cognitive decline in patients with Parkinson’s disease.

They analyzed the levels of glycated hemoglobin (HbA1c) in the blood of 244 patients (159 men and 85 women, mean age at diagnosis, 64.5) enrolled in an observational study at Karolinska University Hospital.

HbA1c is formed when hemoglobin, the protein in red blood cells that carries oxygen, binds to a sugar (glucose) to become glycated. HbA1c is a standard measure of a person’s average blood sugar over the past 60 days.

Based on their HbA1c blood levels, patients were classified into one of three groups: those with low HbA1c (less than 30 nanomoles per mole, mmol / mol), those with low HbA1c levels normal (31-41 mmol / mol) and those with a high level of HbA1c (at least 42 mmol / mol). HbA1c levels were measured for a median of 3.1 years after a person was diagnosed with Parkinson’s disease.

Patients were followed for a minimum of two years to a maximum of 26 years.

Of these 244 people, 184 (75.4%) had normal glucose levels (euglycemia), 17 (7%) had low HbA1c levels, and 18 (7.4%) had high levels. Twenty-five patients (10.2%) were diagnosed with diabetes.

No differences were found for additional laboratory parameters, including plasma albumin, an indicator of malnutrition, and body mass index, a measure of body fat.

Compared with patients with normal HbA1c levels, analyzes revealed that those with low HbA1c were 2.5 more likely to have poorer motor performance. A higher risk of balance problems was observed during follow-up in patients with elevated HbA1c. These results were maintained even after adjusting for age, sex, and vascular risk factors.

Older age (65 years or older) and hypertension were independent predictors of motor outcome disorders.

Mild cognitive impairment (MCI), one of the most common non-motor complications of Parkinson’s disease, was observed in 41% of patients with low HbA1c and 39% with high HbA1c, in 56% of diabetics and in 45% of euglycemic patients. the patients.

Patients with HbA1c levels outside the euglycemia window – that is, those with low and high HbA1c levels – took an average of eight (low) and 6.8 years (high ) to achieve MCI, and 7.1 years for diabetics. In patients with normal HbA1c levels (euglycemia), MCI appeared after a median of 12 years.

However, cognitive decline and HbA1c levels were not significantly associated after adjusting for confounding factors such as age and vascular risk factors.

“[B]high and low levels of HbA1c may be associated with progression of motor symptoms in PD [Parkinson’s disease]The researchers wrote.

“Further prospective and long-term follow-up studies and trials on the effect of altered glycemic control are needed to better understand this link and to determine whether glucose homeostasis [equilibrium] could serve as a therapeutic target, ”they concluded.

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