Clinical Analysis Of Features Of Parkinson's Disease With Diabetes

Background The incidence of diabetes has increased rencently,especially in China.The prevention of diabetes has been known as an important public health event.Age is the biggest risk factor for both Parkinson's disease and diabetes.With the increasing of human life expectancy and the arriving of elderly society,the amount of PD patients in 2030 worldwide is expected to be more than 50% the amount in 2005 over the world.Longterm hyperglycemia has a chronic toxicity to the nervous system,which could lead to the neurological diseasses.In recent years,the relationship between diabetes mellitus and neurodegenerative diseases has become one of the hot spot.Parkinson's disease,second to Alzheimer's disease,is the second largest neurodegenerative disease.So in clinic,Parkinson's disease combined with diabetes is not uncommon.Diabetes could aggravate the motor symptoms and non-motor symptoms of PD.Domestic and foreign literature has reported this phenomenon,but the results are not consistent.Especially,the prospective study of the relationship between PD and diabetes is relatively rare.Objective In this study,we evaluated the effects of diabetes mellitus on the motor symptoms and non-motor symptoms of Parkinson's disease using the related investigation scales for Parkinson's disease.After one year,we observed the changes of corresponding indexes,aimed to analyze and summarize the clinical features of Parkinson disease patients with diabetes.Methods 1.Subjects: we collected 300 PD patients from June 2015 to December 2016 at Parkinson's clinic of General Hospital of Tianjin Medical University;according to the history of diabetes,40 cases of PD patients without diabetes were randomly selected as control group,and 40 PD patients with diabetes were randomly selected as the experimental group,also named Diabetes Group.2.Methods: we collected the basic data of patients,including name,sex,course of disease,age,H-Y grading,medication of Parkinson's disease and diabetes,and including biochemical examination(mainly including blood sugar and blood lipid)and images of brain;we evaluated the basic conditions for both groups,including H-Y grading,daily levodopa equivalent doses,UPDRS-I,UPDRS-III,Mo CA,MMSE,HAMA,HAMD;after a year of observation,the relevant indicators were evaluated again to analyze the severity of the disease,the changes of the symptoms and clinical features.3.Statistical analysis: The collected experimental data were statistically analyzed using the statistical software named Grafpad Prism 5.All the counting data are compared with the chi square test.All P values were selected with bilateral p value,and the difference was statistically significant with p<0.05.Results 1.The differences H-Y grade,LEDD,UPDRS-III,between the experimental group and the control group of PD patients were not statistically significant.One year later,the UPDRS-I,LEDD difference were statistically significant(p= 0.007* and 0.043*);2.At the beginning of the experiment,there were statistically significant differences in the number of NMS in each PD patient between the two groups(p=0.018*).There were statistically significant differences in the frequency of NMS between the two groups,such as drowsiness(p=0.039*),urinary symptom(p=0.021*)and nocturnal urine(p=0.039*).After one year of observation,there was a statistically significant difference in the number of NMS in each PD patient(p=0.001*).Among the two groups,the frequency of NMS was statistically significant(p=0.017*),eachly emotion/cognition(p=0.023*),anxiety(p=0.025*),attention/memory(p=0.033*),difficulty concentrating(p=0.014*),nocturnal urine(p=0.033*)and pain(p=0.021*).3.There were 35%(14/40)PD-MCI and 5%(2/40)PDD in the control group in the initial stage of the experiment,while the diabetes group had 45%(18/40)PD-MCI and 10%(4/40)PDD.There was no statistically significant difference between the PD-MCI and PDD in the two groups.One year later,the control group had 45%(18/40)PD-MCI and 7.5%(3/40)PDD,while the diabetic group were 67.5%(27/40)PD-MCI and 15%(6/40)PDD.The difference of PD-MCI in two groups was statistically significant(p=0.043*).4.In the control group,40.25%(17/40)had anxiety and 30%(12/40)had depression,while the diabetes group had 65%(26/40)suffering from anxiety and 40%(16/40)suffering from depression.There was a statistically significant difference in anxiety between the two groups(p=0.044*),and there was no statistically significant difference in depression(p=0.348).5.There was no statistically significant difference of FPG,Hb A1 c,2h PPG between cognitive dysfunction and non-cognitive dysfunction in diabetic group.There was a statistically significant difference between two groups in the average course of diabetes(p=0.044*),and the average diabetes course in the cognitive impairment group was about 42% longer than that of non-cognitive dysfunction group.Conclusions 1.PD with diabetes could show more non-motor symptoms,mainly cognitive impairment and mental disorders.2.PD with diabetes could exacerbate the clinical symptoms,especially the cognitive dysfunction and mental disorders.3.PD with diabetes couldn't increase the H-Y grades,but would increase the dosage of PD medication.4.The course of diabetes,not the severity of diabetes,could exacerbate the cognitive dysfunction of PD.