Undetected insulin resistance in early Parkinson’s
Original article: High Prevalence of Undiagnosed Insulin Resistance in Non-Diabetic Subjects with Parkinson’s Disease, The Journal of Parkinson’s Disease: March 26, 2018.
A recent study from the US reports that insulin resistance among non-diabetic people with Parkinson’s appears to be higher than anticipated, affecting up to two thirds of this particular sample. Excess weight or obesity, which is often seen in the early stages of Parkinson’s, were strongly associated with insulin resistance.
Why is it important?
This study draws attention to undetected, potentially detrimental, yet reversible insulin resistance in non-diabetic people with Parkinson’s. It serves to highlight additional ways of potentially ameliorating disease progression and improving quality of life.
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This study provides further supports the use of anti-diabetic medications to treat Parkinson’s. It also suggests that insulin resistance could be used to stratify patients for clinical trials, especially when the intervention is a re-purposed diabetes drug.
The link between diabetes and Parkinson’s is in the spotlight, and exciting trials on treatments with disease modifying potential using anti-diabetic drugs are underway. Insulin is the key hormone that regulates blood glucose levels. Loss of sensitivity to the effects of insulin, or insulin resistance, develops in diabetes seen later in life, which in turn increases risk for Parkinson’s. However, abnormal sensitivity to insulin in the absence of diabetes may also be present, especially with advancing age, and can also have harmful effects. Although several studies have addressed the prevalence of diabetes itself in people with Parkinson’s, this is the first to address insulin resistance, that is, an early abnormality in insulin signaling, in peripheral tissues.
154 people with Parkinson’s were recruited into this study, which analysed blood samples, body measurements, demographic information and questionnaires completed by the participants.
The study found that insulin resistance, which had thus far gone undetected, was seen in up to two thirds of the sample. The most important factor associated with this was elevated BMI (body mass index) indicating that people who were overweight or obese were more likely to exhibit insulin resistance. Even among lean people with Parkinson’s, insulin resistance was more prevalent (41%) compared to that normally seen in controls. There was no relationship between insulin resistance and movement, cognition and amount of medications used.
One of the potentially confounding factors in this study is that people were recruited within the context of private healthcare within a largely affluent population. Future studies will be required to investigate whether this greater prevalence of insulin resistance is seen in other populations across the world. If replicated reliably, insulin resistance may become a feature to watch out for in people with Parkinson’s, to be routinely monitored and managed through dietary modifications and exercise.
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Original article: Hogg, E., Athreya, K., Basile, C., Tan, E. E., Kaminski, J., & Tagliati, M. March 26, 2018. High Prevalence of Undiagnosed Insulin Resistance in Non-Diabetic Subjects with Parkinson’s Disease