Glucose dysregulation in Parkinson's disease: a controlled cross-sectional study

Objective: The main objective of our study was to determine whether PD patients with an advanced disease (u003e5 years since diagnosis) have impaired blood glucose levels in response to oral glucose intake. We also aimed to investigate plasma insulin response and urinary glucose, as well as independent associations between blood glucose and clinical parameters including PD severity and autonomic function. Background: Glucose metabolism has recently been reported to be altered in Parkinson’s disease (PD) as a non-motor consequence of the disease, implying that diabetes and PD could share common dysregulated pathways involving insulin response. As insulin pancreatic production and secretion is modulated by the autonomic nervous system, the severity of dysautonomia in PD could be linked with blood glucose dysregulation. Design/Methods: Blood glucose and insulin kinetics during a 75-g Oral Glucose Tolerance Test (OGTT) were compared between 50 PD patients and 50 healthy controls (CT) matched for body mass index (BMI), age and sex. Potential relationships between changes in glucose kinetics and clinical parameters were analyzed including Parkinson’s disease severity and autonomic function using SCOPA-AUT (Scales for Outcomes in Parkinson’s disease, Autonomic dysfunction). Results: Blood glucose was significantly higher at T90 (p=0.04) and T150 (p=0.01) in PD patients compared to CT. Moreover, the total area under time curve (AUC) for the blood glucose levels was significantly higher in PD patients compared to CT (1187 ± 229 vs 1101 ± 201 mmol.min.l-1; p=0.05). Simultaneously, no significant increase of insulin levels was observed in PD patients compared to CT. Higher blood glucose levels were associated with higher BMI (p Conclusions: Glucose control is impaired in advanced non-diabetic PD patients, due to lacking adaptive insulin response which may be a novel non-motor consequence of PD associated dysautonomia. Study Supported by: NA Disclosure: Dr. Marques has nothing to disclose. Dr. Dutheil has nothing to disclose. Dr. Durand has nothing to disclose. Dr. Rieu has nothing to disclose. Dr. Mulliez has nothing to disclose. Dr. Fantini has nothing to disclose. Dr. Boirie has nothing to disclose. Dr. Durif has nothing to disclose.