A pair of studies from the Perelman School of Medicine at the University of Pennsylvania demonstrate a correlation between diabetes severity and parkinsonism, or parkinsonian tremors; and examine the caregiving differences between men and women with PD.

The findings will be presented this week at the American Academy of Neurology’s 67th Annual Meeting in Washington, D.C.   

Diabetes Severity is Associated with Worse Parkinsonism 
The study enrolled 1,100 subjects over the age of 55 without Parkinson’s disease or dementia from the existing Philadelphia Healthy Bran Aging cohort at the University of Pennsylvania. At baseline testing, 34 percent of subjects were found to have diabetes. A Hemoglobin A1c glucose test was performed and a diabetes severity score created that combined the presence of retinopathy, neuropathy, nephropathy and insulin dependence. 

Subjects were then assessed for parkinsonian signs and cognitive impairment. The median hemoglobin A1c was 6.6 (less than 6.5 is ideal in most cases) and the median parkinsonism score was 8.3 (anything above zero is abnormal).  

Higher parkinsonian scores were associated with greater diabetes severity, older age, African-American race and a past history of arthritis. Further analysis showed diabetes severity remained significantly associated with higher parkinsonian sign scores.  

“Our study was based on emerging evidence that the presence of diabetes may increase the risk of both Parkinson’s disease and specific motor features in parkinsonism,” said Nabila Dahodwala, MD, an assistant professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania and director of the National Parkinson Foundation Center of Excellence at the Parkinson's Disease and Movement Disorders Center at Pennsylvania Hospital. 

“We hypothesize that the high burden of cardiovascular risk from diabetes contributes to brain injury, which can impact cognition and parkinsonism,” explains Dahodwala. Further studies are needed to show causality between diabetes and parksonism. These could indicate that aggressive management of diabetes could provide additional motor benefit. 

This work was funded by the Parkinson Council, National Institute on Aging (K23 AG034236 and P30 AG031043) and Penn Minority Aging Research for Community Health (MARCH).

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