Episodes of hypoglycemia in patients with Parkinson's disease - results of two-week continuous glucose monitoring.

AIM OF THE STUDY: Recent evidence suggests that Parkinson's disease (PD) and glucose metabolism disorders may share some common dysregulation pathways. This study sought to determine the incidence of hypoglycemic episodes in PD patients and identify associated risk factors for these events.

CLINICAL RATIONALE FOR THE STUDY: Hypoglycemia in PD, especially at night, is not well understood. This study quantified hypoglycemia in PD patients and identified autonomic dysfunction as a key risk factor, providing new insights for research into metabolic aspects of PD.

MATERIAL AND

METHODS

Thirty-five patients diagnosed with PD and 20 control subjects underwent a study consisting of a clinical and biometric assessment and two weeks of continuous glucose monitoring using the Freestyle Libre system to detect episodic hypoglycemia.

RESULTS

Among PD patients, 18 (51.4%) had episodes of hypoglycemia, and 67.8% of the events occurred between 0:00 and 6:00 a.m. Compared to the control group, there were significantly more hypoglycemic episodes registered in PD patients (3.6/pt vs. 1.4/pt; p = 0.0006). Predictors of the occurrence of hypoglycemic episodes in the PD group were lower two-week average glycemic levels (OR: 0.85, p = 0.016), glycemic variability index (OR: 1.46, p = 0.02), and SCOPA-AUT scale score (OR: 1.23, p = 0.04).

CONCLUSIONS AND CLINICAL IMPLICATIONS: Patients with PD are at higher risk of hypoglycemic episodes, especially at night and in the morning. Patients with autonomic dysfunction are at risk for hypoglycemic episodes. Recognizing hypoglycemic episodes can enhance the management of PD by enabling targeted interventions aimed at reducing glycemic variability.