Objective: To determine if type 1 diabetes (T1DM) mellitus patients with Parkinson’s disease (PD) exhibit similar characteristics of disease progression as T1DM patients without PD.

Background: Previously published studies have shown that increased inflammatory mediators in autoimmune disease such as T1DM may activate microglia, and cause degeneration of dopaminergic neurons in the brain [1]. To study PD in a high-risk population of T1DM patients, we used the standardized, well-established German/Austrian diabetes follow-up registry, DPV (www.d-p-v.eu).

Methods: We included 18,162 T1DM patients aged ≤40 years who were eligible for the study (mean age ± SD: 57.6±12.0 years, 54.3% males). Besides diabetes data, co-morbid diagnoses such as PD are documented in the registry. ICD-10-codes, specific search terms for a PD diagnosis and/or drugs specific for PD therapy were used to select patients with comorbid clinically recognized PD4. Renal failure was defined as estimated GFR <15ml/min/1.73m² using MDRD formula and/or renal transplantation or dialysis. Multivariable regression analyses were used to compare T1DM with PD and T1DM without PD, with age, sex and diabetes duration as covariates. All statistical analysis were performed using SAS version 9.4. Bonferroni-Holm correction was applied to adjust for multiple comparisons. Significance was set at a two-sided p<0.05.

Results: Our study observed renal failure to be more likely in PD patients (OR [95%CI] =3.9 [2.2-7.2], p<0.0001). Dementia also presented more frequently in PD patients (OR=2.0 [1.2-3.4], p=0.01). As a measure of disease management, hospitalization (OR=2.0 [1.2-3.1], p=0.006) was more likely in PD patients. Macrovascular risk factors and endpoints such as stroke, diabetic foot syndrome, and lipid levels were comparable between PD and non-PD patients (p>0.1).

Conclusions: Increased risk of renal complications, hospitalization and dementia should be taken into consideration for management of PD patients with T1DM. Moreover, clinicians should be aware of novel treatment options, and influence of potential drug interaction in patients with PD and T1DM. 1.Gorelick PB. Role of inflammation in cognitive impairment: results of observational epidemiological studies and clinical trials. Annals of the New York Academy of Sciences 2010;1207:155-162.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/disease-progression-and-clinical-characteristics-of-parkinsons-disease-patients-with-type-1-diabetes-an-analysis-on-18162-patients-from-the-dpv-registry/