JORNADA AVENÇOS

Diabetes Mellitus, Obesity, and Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Study. JAMA Neurol.2015 JunConclusions and Relevance: In this Danish nationwide study to investigate the association between diabetes and ALS diagnosis, our findings are in agreement with previous reports of a protective association between vascular risk factors and ALS and suggest that type 2 diabetes, but not type 1, is protective for ALS.

An earlier diagnosis could make it possible for patients to take part in clinical trials and to receive multidisciplinary care from the early stage of the disease, possibly leading to longer survival (Tray-

nor et al., 2003; Miller et al., 2009). Although recent studies have re- ported some candidate biomarker which support a diagnosis of ALS (Fialova et al., 2010; Ryberg et al., 2010; Kasai et al., 2009; Noto et al., 2010), there is no established diagnostic biomarker of ALS in the early stage. The diagnostic reliance is currently based on a combina- tion of clinical and electrophysiological

finding

Fasciculation potentials: a diagnsotic biomarker of early ALS?(Eisen 2013)

Mechanisms, models and biomarkers in amyotrophic lateral sclerosis.(Turner MR, 2013)The lack of useful biomarkers in ALS contributes to diagnostic delay, and the inability to stratify patients by prognosis may be an important factor in the failure of

therapeutic trials. .