ALS disease onset may occur later in patients with pre-morbid diabetes mellitus

A. Jawaid, A. R. Salamone, A. M. Strutt, S. B. Murthy, M. Wheaton, E. J. McDowell, Ericka P. Greene, Stanley H. Appel, M. K. York, P. E. Schulz

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Background Several metabolic derangements associated with diabetes mellitus type 2 (DM) have been associated with a better outcome in amyotrophic lateral sclerosis (ALS), including hyperlipidemia and obesity. Here, we tested the hypothesis that DM would have a positive effect on the motor and cognitive findings of ALS. Methods: We compared data from ALS patients with pre-morbid DM (ALS-DM; n = 175) versus without DM (ALS; n = 2196) with regard to the age of onset, rate of motor progression, survival, and neuropsychological test performance. Results: The age of onset was later for women, Caucasians and patients with bulbar-onset ALS. However, we also found that after adjusting for gender, ethnicity and site of onset, DM was associated with a 4-year later onset of ALS (ALS = 56.3, ALS-DM = 60.3, P < 0.05). Conclusion: Diabetes mellitus type 2 may delay the onset of motor symptoms in ALS. These findings support other studies suggesting a relationship between the pathophysiology of ALS and metabolic derangements. Further investigations are needed to ascertain whether manipulating metabolic parameters would improve outcomes in ALS.

Original languageEnglish (US)
Pages (from-to)733-739
Number of pages7
JournalEuropean Journal of Neurology
Issue number5
StatePublished - May 2010


  • Amyotrophic lateral sclerosis
  • Cognition
  • Diabetes mellitus
  • Onset
  • Progression
  • Survival

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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