Patients who had diabetes when diagnosed with amyotrophic lateral sclerosis (ALS) were on average quicker to lose their ability to walk compared to ALS patients without diabetes.
Japanese researchers published their study — Factors Influencing the Loss of Ambulation in Patients with Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study — in Health Science Reports in September.
A retrospective cohort study examines pre-existing records and information from groups — i.e., cohorts — of patients, in this case, adults with ALS.
In this study, researchers examined records of patients who’d been diagnosed with diabetes before later being diagnosed with ALS, and compared their records and outcomes to patients who were diagnosed with ALS, but had no history of diabetes.
The researchers found that ALS patients without diabetes lost their ability to walk 16.5 months after diagnosis on average, while ALS patients who’d previously been diagnosed with diabetes lost their ability to walk an average of 10 months after receiving their ALS diagnosis.
Study authors noted that hyperglycemia — high blood sugar levels — “increase oxidative stress and degenerates motor nerves. Additionally, diabetes mellitus (DM) and ALS patients have difficulty producing and regulating insulin-like growth factor-1 (IGF-1), which promotes muscle hypertrophy and neuronal survival.” That decrease in IGF-1 could contribute to ambulatory impairment.
The researchers added that the inability to walk was a major obstacle according to ALS patients and their caregivers, as it impacted social participation and quality of life. A better understanding of “risk factors for ambulation prognosis” at the time patients are diagnosed with ALS could improve clinicians’ ability to recommend more effective treatment and goal setting.
The 62 patients — 41 male and 21 female — whose records were examined for the study were all connected with the Department of Neurology at Saku Central Hospital in Nagano, Japan. All of the patients in the study underwent rehabilitation related to their ALS diagnoses. None of these patients had the familial form of ALS.
“Early implementation of walking aids and orthotic interventions is important for ALS patients with DM history,” the authors said.
