The question of the relationship between the occurrance of diabetes and
Parkinson's was not found to be significant. The third abstract deals with
the complications of having untreated hyperglycemia and levodopa medications
used in Parkinson's.
<1>
Authors
Gorell JM. Johnson CC. Rybicki BA.
Institution
Department of Neurology, Henry Ford Hospital & Health Sciences Center,
Detroit, MI 48202.
Title
Parkinson's disease and its comorbid disorders: an analysis of Michigan
mortality data, 1970 to 1990.
Source
Neurology. 44(10):1865-8, 1994 Oct.
Abstract
Using data from death certificates, we compared underlying causes of death
for two populations of Michigan decedents: (1) persons 40 years of age and
older for whom Parkinson's disease (PD) was listed as a contributing cause
of death and who died in the years 1970 through 1989, and (2) all persons
in Michigan over 40 years of age who died in 1970, 1980, or 1990. PD
decedents were approximately 1.5 times more likely to die from
cerebrovascular disease and three to four times more likely to die from
pneumonia/influenza, but they had just 29% of the expected number of
deaths due to cancer. These associations were maintained irrespective of
gender or race. PD decedents had diabetes mellitus and heart diseases as
frequently as decedents in the general population, but liver diseases were
less frequent among PD decedents. These trends held throughout the 21-year
study period. When we stratified cancers by whether they are known to be
(1) highly related, (2) moderately related, or (3) weakly related or
unrelated to smoking, there were still 2.5 times fewer cancers unrelated
or weakly related to smoking among PD decedents than among decedents in
the general population. We believe that the greater frequency of
cerebrovascular disease in PD decedents may be due to a detection bias,
since PD patients are more likely to be seen by neurologists, who are more
apt to diagnose and document diseases of the nervous system.
Pneumonia/influenza is more common among PD patients because of their
relative immobility near the end of life.(ABSTRACT TRUNCATED AT 250 WORDS)
<2>
Authors
Morano A. Jimenez-Jimenez FJ. Molina JA. Antolin MA.
Institution
Department of Neurology, Hospital Virgen del Puerto, Plasencia, Caceres,
Spain.
Title
Risk-factors for Parkinson's disease: case-control study in the province
of Caceres, Spain. [Review]
Source
Acta Neurologica Scandinavica. 89(3):164-70, 1994 Mar.
Abstract
This case-control study, performed in a mixed rural and urban province, of
74 patients with Parkinson's disease (PD) and 148 unselected age and
sex-matched controls, attempted to look possible risk factors for PD.
Rural living, well-water drinking, positive family history for PD and
postural tremor, were associated to an increased risk for PD, with results
regarding exposure to pesticides near to statistical significance.
Alcohol-drinking habit in males were associated to a decreased risk for
PD, with results regarding cigarette-smoking habit in males near to
statistical significance. We did not find association between the risk for
PD and the following variables: 1) exposure to industrial toxins; 2)
agricultural work; 3) cranial trauma; 4) previous common illnesses
including some infections, arterial hypertension, diabetes mellitus,
coronary heart disease and thyroid disease; 5) coffee and tea drinking
habits. [References: 92]
<3>
Authors
Sandyk R.
Institution
NeuroCommunication Research Laboratories, Danbury, CT.
Title
The relationship between diabetes mellitus and Parkinson's disease.
[Review]
Source
International Journal of Neuroscience. 69(1-4):125-30, 1993 Mar-Apr.
Abstract
It has been reported that 50% to 80% of patients with Parkinson's disease
have abnormal glucose tolerance which may be further exacerbated by
levodopa therapy. Little is known about the impact of chronic
hyperglycemia on the severity of the motor manifestations and the course
of the disease as well as its impact on the efficacy of levodopa or other
dopaminergic drugs. This issue, which has been largely ignored, is of
clinical relevance since animal studies indicate that chronic
hyperglycemia decreases striatal dopaminergic transmission and increases
the sensitivity of postsynaptic dopamine receptors. In addition, evidence
from experimental animal studies indicates that diabetic rats are
resistant to the locomotor and behavioral effects of the dopamine agonist
amphetamine. The resistance to the central effects of amphetamine is
largely restored with chronic insulin therapy. In the present
communication, I propose that in Parkinson's disease diabetes may
exacerbate the severity of the motor disability and attenuate the
therapeutic efficacy of levodopa or other dopaminergic agents as well as
increase the risk of levodopa-induced motor dyskinesias. Thus, it is
advocated that Parkinsonian patients should be routinely screened for
evidence of glucose intolerance and that if found aggressive treatment of
the hyperglycemia may improve the response to levodopa and potentially
diminish the risk of levodopa-induced motor dyskinesias. [References: 55]
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