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Information on <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content> and pre\u2010existing diabetes was retrieved from the Swedish Patient Register to explore the association of <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content> with diabetes overall and with insulin\u2010dependent or non\u2010insulin\u2010dependent diabetes specifically. Variation of the association by diabetes duration and age was also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 224 <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content> cases (4.39%) and 1437 controls (5.63%) had diabetes before the index date, leading to an overall inverse association between diabetes and <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content> risk [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>)\u00a00.79, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)\u00a00.68\u20130.91]. The association was strong for non\u2010insulin\u2010dependent diabetes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a00.66, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a00.53\u20130.81) but not for insulin\u2010dependent diabetes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a00.83, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a00.60\u20131.15) and varied as a function of diabetes duration, with the strongest association observed around 6\u00a0years after first ascertainment of diabetes. The association was age\u2010specific; the inverse association was noted only amongst individuals aged 70 or older. In contrast, for younger individuals (&lt;50\u00a0years), pre\u2010existing insulin\u2010dependent diabetes was associated with a higher <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content> risk (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a05.38, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a01.87\u201315.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study suggests that there is an association between diabetes and <jats:styled-content style=\"fixed-case\">ALS<\/jats:styled-content>, and highlights the importance of taking into account age, insulin dependence and diabetes duration. Future studies should explore whether the association is independent of body mass index.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12632","type":"journal-article","created":{"date-parts":[[2015,1,19]],"date-time":"2015-01-19T13:38:45Z","timestamp":1421674725000},"page":"1436-1442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["Association between diabetes and amyotrophic lateral sclerosis in <scp>S<\/scp>weden"],"prefix":"10.1111","volume":"22","author":[{"given":"D.","family":"Mariosa","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park NC 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