The role of pre-morbid diabetes on developing Amyotrophic Lateral Sclerosis

Background The literature on the association between diabetes and Amyotrophic Lateral Sclerosis (ALS) counts a limited number of studies. This cohort study was developed in order to assess the role of diabetes on the risk of developing ALS. Methods The study population was represented by all residents in Turin (Italy) at the beginning of 1996, already present at 1991 Census, older than 14 years (n=727,977), followed up for ALS occurrence from 1998 to 2014. Presence of diabetes at baseline or during the follow-up was ascertained through two Piedmont regional sources: the Diabetes Registry and the ATC Drugs Prescriptions Archive. The risk of ALS was estimated using the Piedmont and Valle d'Aosta ALS Registry (PARALS). The association of diabetes, treated as a time-dependent variable, with ALS onset was estimated through Cox proportional hazard regression models adjusted for age, gender, education and marital status. Results During the follow-up, 397 subjects developed ALS, 24 of whom were already diabetics before ALS onset. Diabetes was associated with a significantly decreased the risk of ALS (HR=0.30; 95% CI: 0.19-0.45), without differences in risk by gender, age class or ALS phenotype. Conclusions The study results support the protective role of diabetes toward ALS. This article is protected by copyright. All rights reserved.