Diabetes adds greater risk of mobility loss in ALS: Study
Researchers urge implementing walking aids earlier in process
People with amyotrophic lateral sclerosis (ALS) who also have diabetes tend to lose the ability to walk faster than non-diabetic patients, according to a study from Japan.
The findings underscore the importance of supportive mobility care for diabetic ALS patients, scientists said in the study, “Factors Influencing the Loss of Ambulation in Patients With Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study,” published in Health Science Reports.
ALS is a neurological disorder that causes progressive muscle weakness, causing patients to gradually lose the ability to walk and perform other movements needed for daily life.
Problems walking “reduce social participation and quality of life and are among the most considerable obstacles experienced by the patients and their caregivers,” the researchers said.
However, little is known about factors that may be associated with earlier or later loss of walking ability.
“If the risk factors for ambulation prognosis are identified at the time of diagnosis, clinicians may be able to apply them clinically as useful information for treatment planning and goal setting,” the scientists wrote.
Japanese study investigates mobility loss
A trio of scientists in Japan set out to identify factors associated with loss of ambulation using data from 62 people with ALS who received care at their clinic.
During follow-up, all those studied eventually lost the ability to walk. The median time from diagnosis to loss of walking ability was 16.5 months, but some retained the ability to walk for nearly double that time, while others lost the ability to walk around 10 months after diagnosis.
Statistical analyses showed the time to loss of walking ability was significantly shorter among those who had diabetes. The median time to loss of ambulation in diabetic patients was about a year, whereas in non-diabetic patients it was closer to 1.5 years.
After adjusting for factors such as age at disease onset, sex, initial symptoms, disease severity, and lung function, having diabetes was linked to a 3.3 times greater risk of earlier loss of walking ability.
“In our study, patients with a history of [diabetes] had a shorter time to loss of ambulation than those without [diabetes],” the researchers wrote. “Early implementation of walking aids and orthotic interventions is important for ALS patients with [diabetes] history.”
The researchers noted that diabetes — a metabolic disorder marked by high blood sugar — can cause muscle weakness, which may explain this result. The problem may also stem from low levels of certain signaling molecules that promote muscle and nerve health in people with diabetes.
The analyses also found a shorter delay between symptom onset and diagnosis was significantly associated with an earlier loss of ambulation. Previous studies have found similar associations, and the researchers said these correlations likely reflect the fact people with more aggressive, rapidly-progressing disease are usually diagnosed faster.
The researchers emphasized that their study was limited to a small number of people followed at one center, so further work will be needed to validate the findings and explore the underlying biological mechanisms.
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