Pre-morbid type 2 diabetes mellitus is not a prognostic factor in amyotrophic lateral sclerosis

Muscle Nerve. 2015 Sep;52(3):339-43. doi: 10.1002/mus.24688. Epub 2015 Jun 1.

Abstract

Introduction: The aim of this study was to determine whether a history of pre-morbid type 2 diabetes mellitus (DM2) is a prognostic factor in amyotrophic lateral sclerosis (ALS).

Methods: The relationship between DM2 and survival was analyzed in a study population consisting of 1,322 participants from 6 clinical trials.

Results: Survival did not differ by diabetes status (log-rank test, P = 0.98), but did differ by body mass index (BMI) (log-rank test, P = 0.008). In multivariate analysis, there was no significant association between diabetes and survival (P = 0.18), but the risk of reaching a survival endpoint decreased by 4% for each unit increase in baseline BMI (HR 0.96, 95% CI 0.94-0.99, P = 0.001). DM2 was less prevalent among ALS clinical trial participants than predicted.

Conclusions: A history of pre-morbid DM2 is not an independent prognostic factor in ALS clinical trial databases. The low DM2 prevalence rate should be examined in a large, prospective study to determine whether DM2 affects ALS risk.

Keywords: ALS; BMI; diabetes; prognosis; survival.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / epidemiology
  • Amyotrophic Lateral Sclerosis / mortality*
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Survival Rate