| BackgroundAs the global incidence of diabetes increased rapidly in recent years, there are more and more Parkinson’s patients with diabetes in clinical practice. It has been reported that diabetes can aggravate the motor symptoms of Parkinson’s disease, such as muscle rigidity and gait abnormalities at home and abroad, but few reports mention the effects of diabetes on the non-motor symptoms.In view of the current consensus on Parkinson’s disease treatment, in addition to the motor symptoms, the improvement of the non-motor symptoms in patients is getting increasing attention.ObjectiveThis study analyses the different manifestations of the NMSs between Parkinson’s patients with diabetes and those without diabetes, and assesses the effects of diabetes on the NMSs of Parkinson’s disease.Methods1.Subjects:We enrolled200Parkinson’s patients who visited the neurology clinic at QiLu Hospital between February2013and January2014, and selected30patients with diabetes history, then each of whom was paired with one patient without diabetes history by sex and years of disease duration.2. Methods: We collected the basic information of the60patients, including name,sex, age, years of disease duration, H-Y staging and medical dosage.We assessed the non-motor symptoms of the60patients using the NMSS. The score of each item is the product of the severity(from0to3) and frequency(from1to4). We also scored each individual NMS as being ’present’ or’absent’ in order to analyze the prevalence of each NMS.3. Statistical analysis:SPSS17.0for Windows was used for the statistical analysis. Wilcoxon signed rank test was used to compare the difference in demographic data (sex, age, and years of disease duration). Paired t-test for dependent sample was used to compare the difference of H-Y staging, madopar equivalent dose (MED) and the total scores of the NMSS between the diabetes group and the control group. X2test (fisher’s exact test) was used to analyze the prevalence of each NMS of the two groups. Wilcoxon signed rank test was also used to analyze each NMS scores between the two groups. The level of statistical significance was set at p<0.05. The p value was bilateral.Results1.The average H-Y staging is2.63±1.29in the diabetes group, while that is2.40±0.86in the control group. The difference is of no significance (p=0.152). The mean madopar equivalent dose in the diabetes group is (530.63±261.09)mg, and (522.95±246.03)mg in the control group. The difference is of no significance (p=0.632).2. In the diabetes group, the mean number of the NMSs per subject is18.27±3.39, while that is16.20±3.75in the control group. The number of the NMSs of each subject in the two groups is of significance(p=0.011), the diabetes group is12.8%higher than the control group. In the diabetes group, the mean of the total score of the NMSS is97.00±31.39, while that is91.73±40.33in the control group, the total scores of the NMSS in the two groups are of no significance (p=0.438). The frequency of the NMSs in the diabetes group is significantly higher than the control group in the following aspects:sleepiness(p=0.011), perceptual problems and hallucinations (p=0.037), gastrointestinal tract symptoms(p=0.024). The scores of the NMSS are significantly higher than the control group in the following aspects: sleepiness(p=0.001), depression(p=0.016) and sexual function(p=0.011).ConclusionsDiabetes can increase the number of the non-motor symptoms in patients with Parkinson’s disease, in general, idiopathic Parkinson’s patients with diabetes show more non-motor symptoms than non-diabetic patients. The incidence of idiopathic Parkinson’s patients with diabetes is significantly higher than non-diabetic patients on drowsiness, hallucinations and perception, gastrointestinal symptoms. Diabetes dose no significant effect on the overall severity of the non-motor symptoms in Parkinson’s patients, but idiopathic Parkinson’s patients with diabetes show significantly worse in individual non-motor symptoms compared with non-diabetic patients, such as drowsiness, depression and sexual function changes. |
