Diabetes Mellitus and Amyotrophic Lateral Sclerosis: A Systematic Review

We focus on the role of Diabetes Mellitus in Amyotrophic Lateral Sclerosis, examining the different hypotheses on how perturbations of glucose metabolism may interact with the pathophysiology and the course of ALS

Laura Ferri

Scholarcy highlights

  • To elucidate the molecular mechanisms underlying the extra-neural pathology of Amyotrophic Lateral Sclerosis, some authors focus on TAR DNA-binding protein 43 kDa which is found in 90–95%
  • On the other hand, contrasting data suggested a protective role of Diabetes Mellitus on the occurrence of ALS in elderly subjects and an inverse correlation in younger
  • We describe how the multiple attempts to shed light on the relationship between DM and ALS may be hindered by several shortcomings
  • The major limit of the above-mentioned studies is the difficulty in designing a study considering the dynamic course of DM, including measures of glycaemia control, and taking into account the wide range of co-variables associated with DM, as short and long term DM complications, in patients with ALS, which should partially justify the heterogeneity of currently available data
  • Glucagon; ApoE: Apolipoprotein E; OR: Odds Ratio; hazard ratio: Hazard Ratio; 95% CI: 95% Confidence Intervals; SD: Standard Deviation; RCT: Randomized Clinical Trail; HbA1c: Glycated Hemoglobin
  • Achieving large sample sizes comparable to those of common complex diseases like DM is a challenge for a rare disease like ALS
  • Despite discrepancies and limits of the available studies, considering the growing evidence of insulin-resistance involvement in other neurodegenerative diseases such as Alzheimer’s Disease and Parkinson’s Disease , we suggest that further efforts in determining the role of glucidic metabolism in Amyotrophic Lateral Sclerosis would be crucial

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