Diabetes Mellitus and Parkinson’s Disease: A Systematic Review and Meta-Analyses

Article type: Research Article

Authors: Komici, Klara^a | Femminella, Grazia Daniela^b | Bencivenga, Leonardo^{b; c} | Rengo, Giuseppe^{b; d} | Pagano, Gennaro^{e; f; *}

Affiliations: [a] Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy | [b] Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy | [c] Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy | [d] Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), Scientific Institute of Telese Terme, Telese Terme (BN), Italy | [e] King’s College London, London, UK | [f] Roche Pharma Research and Early Development (pRED), Neuroscience and Rare Diseases Discovery and Translational Area, Roche Innovation Center, Basel, Switzerland

Correspondence: [*] Correspondence to: Gennaro Pagano, MD, MSc, PhD, Chair of Medical Directors Fellowship program, Expert Medical Director & Group Leader in Neuroscience and Rare Diseases, Roche Pharma Research and Early Development (pRED), Basel, Switzerland. E-mail: [email protected].

Abstract: Background:A link between diabetes mellitus (DM) and Parkinson’s disease (PD) have been proposed but evidence are sparse and inconsistent. Objective:Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression. Methods:MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD. Results:A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 –12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26–1.43 p < 0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12–0.60; p < 0.001) and higher UPDRS (SMD 0.60 95%CI 0.28–0.92; p < 0.001) compared with PD patients without DM. Conclusion:Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.

Keywords: Parkinson’s disease, diabetes mellitus, hyperglycaemia, insulin sensitivity, neurodegeneration

DOI: 10.3233/JPD-212725

Journal: Journal of Parkinson's Disease, vol. 11, no. 4, pp. 1585-1596, 2021