From: Effects of diabetes mellitus on amyotrophic lateral sclerosis: a systematic review
Authors, Year of publication | Country setting | Design period of study | Population characteristics | ALS diagnostic criteria | Diabetes mellitus and pre-diabetes states diagnostic criteria | Outcomes of interest | Comments including association between DM and risk of ALS onset, progression or survival |
---|---|---|---|---|---|---|---|
Jawaid [7], 2010 | USA Hospital-based | Case–control | N: 274 | El Escorial criteria | Not provided | Rate of progression beta coefficient (95% CI): -0.07 (-2.40-0.74), P =0.30 | Adjustment performed for possible confounders including BMI change, gender, APoE genotype and Site of onset, |
1999-2004 | Age: 52y | Survival beta coefficient (95% CI) 0.10 (-0.93-3.49) P =0.25 | |||||
M: 171 | |||||||
Patient with pre-morbid DM were compared with patients without pre-morbid DM | |||||||
Jawaid [8], 2010 | USA Hospital-based | Retrospective Case–control 1984-2007 | Cases (ALS with pre-morbid DM): | El Escorial criteria | Diabetes mellitus | Age of onset in years: ALS with DM 60.3 vs. ALS without DM: 56.3 (p < 0.02) | Adjustment performed for possible confounders including gender and site of onset |
N: 175 | Two FBG ≥ 126 mg/dl or two RBG ≥ 200 mg/dl at or before the time of ALS diagnosis. | Rate of progression (AALS/month): ALS with DM 3.58 vs. ALS without DM: 3.01 (p: NS) | |||||
Age: 60y | Survival (years): ALS with DM: 3.60 vs. ALS without DM 3.04 (p: NS) | ||||||
M: 62 | |||||||
Control (ALS without pre-morbid DM): | |||||||
N: 2196 | |||||||
Age: 56y | |||||||
M: 66 | |||||||
Pradat [9], 2010 | France Hospital-based | Case–control | ALS: | El Escorial criteria | 75 g OGTT | Prevalence of IGT in ALS vs. control (33% vs. 9.5% p =0.13) | OGTT compared between ALS patients and controls. |
N: 21 (including 7 with IGT) | DM: FPG > 7.0 mmol/l or the 2-h post-load blood glucose concentration > 11.0 mmol/l. | Disease duration ALS with IGT vs. ALS without IGT (17 months vs. 20 months, p = 0.62), | No adjustment performed for possible confounders with IGT vs. ALS without IGT (17 months vs. 20 months, p = 0.62), | ||||
Age: 53y | IFPG: FPG between 6.1 and 7.0 mmol/l. | ALSFRS ALS with IGT 35 months vs. ALS without IGT 35 months, p = 0.89) | |||||
M: 86% | IGT: FPG < 7.0 mmol/l and 2-h blood glucose of 7.8-11.0 mmol/l | ||||||
Control (non ALS): | |||||||
N: 21 | |||||||
Age: 53y | |||||||
M: 86% | |||||||
Ionacescu [10], 1968 | Romania Hospital based | Cross-sectional | N: 18 participans with ALS | Clinical diagnosis: signs of peripheral motor neuron disease in upper and lower limbs + pyramidal signs | Not provided | Abnormal OGTT: 50% | |
Age: 52y | Exaggerated sensitivity to insulin: 61% | ||||||
M: 10 | |||||||
Koerner [12], 1976 | USA Hospital-based | Retrospective Cross sectional | N: 34 participants with ALS | NA | USPHS criteria/100 g glucose load: | 56% of ALS patient had an IGT or DM | Authors reported that the frequency of IGT and DM in ALS participants was higher than in other Asian pacific regions and USA |
IGT: 2-hour post glucose load > mean + 2SD | |||||||
Age: NA | |||||||
M: NA | |||||||
Harno [11], 1984 | Finland Hospital based | Case–control | Cases: | Clinical and ENMG signs of lower motor neuron disease. Signs of upper motor neuron disease could be present | Diabetes: FPG of ≥140 mg/dL (7.8 mmol/L) or a 2-hour PG ≥ 200 mg/dL in an OGTT | Diabetes: | No adjustment for possible confounders |
N: 21 | IGT: FPG <7.8 mmol/l, PG-1 h >11.1 mmol/l, PG-2 h 7.8-11.0 mmol/l) | Case: 5% | |||||
Age: 59y | PG-1 h >11.1 mmol/l, PG-2 h 7.8-11.0 mmol/l) | Control: 10% | |||||
M: 14 | OR = 0.45 (95% CI: 0.03-8.02) | ||||||
Control | Abnormal OGTT: | ||||||
N: 10 | Case: 19% | ||||||
Age: 61y | Control: 20% | ||||||
M:2 | OR = 0.94 (95% CI: 0.14-6.25) | ||||||
Armon [13], 1991 | USA Population-based | Retrospective Case–control 1925-87 | N: 45 | NA | Not provided “Diabetes as diagnosed and treated by physicians” | Diabetes: | No adjustment for possible confounders |
Age: 68y | OR = 1 (0.29-3.5) | ||||||
M:51% | Case: 13% | ||||||
Controls | Control: 13% | ||||||
N: 90 | |||||||
Age: NA | |||||||
M: NA |