Association between type 1 diabetes mellitus and risk of epilepsy: A meta-analysis of observational studies

Yan, Dandan; Zhao, Enfa; Zhang, Hong; Luo, Xiaohui; Du, Yajuan

doi:10.5582/ddt.2017.01020

Cited by 13 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is also some evidence that pointed out that diabetes mellitus is expressively associated with increased risk of epilepsy compared to nondiabetic patients [56–58]. Hence, it is fascinating that metformin might be a potential and promising pharmacological agent particularly for patients who have concurrent conditions of diabetes mellitus and epilepsy.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Metformin in Experimentally Induced Animal Models of Epileptic Seizure

Yimer

Surur

Wondafrash

et al. 2019

Behavioural Neurology

View full text Add to dashboard Cite

Background. Epilepsy is one of the common neurological illnesses which affects millions of individuals globally. Although the majority of epileptic patients have a good response for the currently available antiepileptic drugs (AEDs), about 30-40% of epileptic patients are developing resistance. In addition to low safety profiles of most of existing AEDs, there is no AED available for curative or disease-modifying actions for epilepsy so far. Objectives. This systematic review is intended to evaluate the effect of metformin in acute and chronic animal models of an epileptic seizure. Methods. We searched PubMed, SCOPUS, Sciences Direct, and grey literature in order to explore articles published in English from January 2010 to November 2018, using key terms “epilepsy,” “seizure,” “metformin,” “oral hypoglycemic agents,” and “oral antidiabetic drugs”. The qualities of all the included articles were assessed according to the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES). Results. Out of six hundred fifty original articles retrieved, eleven of them fulfilled the inclusion criteria and were included for final qualitative analysis. In these studies, metformin showed to control seizure attacks by attenuating seizure generation, delaying the onset of epilepsy, reducing hippocampal neuronal loss, and averting cognitive impairments in both acute and chronic models of an epileptic seizure. The possible mechanisms for its antiseizure or antiepileptic action might be due to activation of AMPK, antiapoptotic, antineuroinflammatory, and antioxidant properties, which possibly modify disease progression through affecting epileptogenesis. Conclusion. This review revealed the benefits of metformin in alleviating symptoms of epileptic seizure and modifying different cellular and molecular changes that affect the natural history of the disease in addition to its good safety profile.

show abstract

Section: Resultsmentioning

confidence: 99%

The Effect of Metformin in Experimentally Induced Animal Models of Epileptic Seizure

Yimer

Surur

Wondafrash

et al. 2019

Behavioural Neurology

View full text Add to dashboard Cite

show abstract

“…A disorder of particular interest is diabetes [6][7][8][9]. The connection between epilepsy and type 1 diabetes mellitus (T1DM) has already been highlighted [10][11][12][13][14][15][16][17][18][19][20]. A recent meta-analysis found that people with T1DM have a 2 to 6 fold increased risk of epilepsy than the general population [20].…”

Section: Introductionmentioning

confidence: 99%

Drivers for the comorbidity of type 2 diabetes mellitus and epilepsy: A scoping review

Shlobin

Sander

2020

Epilepsy & Behavior

View full text Add to dashboard Cite

Epilepsy, a common neurologic condition, is associated with a greater prevalence of type 2 diabetes mellitus (T2DM). We examined potential drivers for the comorbidity of epilepsy and T2DM in an attempt to elucidate possible biological mechanisms underlying the development of processes in individuals. We searched PubMed and Medline up to December 2019. Our search yielded 3,361 articles, of which 82 were included in the scoping review. We reviewed articles with a focus on the association of epilepsy and T2DM, drivers, and biological mechanisms. Epilepsy is associated with obesity and obesity is associated with T2DM. Treatment with valproate (either sodium or acid) is associated with weight increase and hyperinsulinemia, while topiramate causes weight loss. People with epilepsy are less likely to exercise which is protective against obesity. Mitochondrial dysfunction and adiponectin deficiency are common to epilepsy and T2DM. One possible mechanism for the comorbidity is mitochondrial dysfunction and adiponectin deficiency which promotes epilepsy, obesity, and T2DM. Another possible mechanism is that people with epilepsy are more likely to be obese due to lack of exercise and the effects of some antiseizure medications, which makes them susceptible to T2DM due to the development of mitochondrial dysfunction and adiponectin deficiency. A third mechanism is that people with epilepsy have greater mitochondrial dysfunction and lower adiponectin levels than people without epilepsy at baseline, which may exacerbate after treatment with antiseizure medications. Future research involving a combined genetic and molecular pathway approach will likely yield valuable insight regarding the comorbidity of epilepsy and T2DM.

show abstract

“…T1DM is comorbid with epilepsy, with a hazard ratio of 2.89 [4] , [5] , [6] . Most T1DM patients are diagnosed with diabetes on average 2.8 years prior to their epilepsy, in this patient, the opposite was true [4] .…”

Section: Discussionmentioning

confidence: 99%

“…Independent of risks of seizure from low or elevated glucose levels, individuals with T1DM may be prone to reflex epilepsy, our patient has a history reflex/audiogenic seizure, though we do not know which of her seizures were audiogenic to then correlate her glucose or laterality with [18] . There may be shared autoimmune risks due to anti-GAD antibody present in up to 80% type I diabetics and 6% of people with epilepsy [4] , [5] , [6] . GAD helps convert glutamate to gamma-aminobutyric acid (GABA), that process is contingent also on glucose through citric acid cycles.…”

Section: Discussionmentioning

confidence: 99%

“…Regional glucose uptake or hypometabolic changes in possible epileptogenic tissue may become evident with 18F-fluoro-deoxyglucose (FDG) positron emission tomography (PET) mapping [3] . In patients with type 1 diabetes mellitus (T1DM), seizures may be provoked with hypo-, hyper- and ketotic glycemia [4] , [5] , [6] . Yet how alterations in glucose change seizure susceptibility is not well described.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Continuous monitoring devices and seizure patterns by glucose, time and lateralized seizure onset

Kinnear¹,

Warner²,

Haltiner³

et al. 2018

Epilepsy & Behavior Case Reports

View full text Add to dashboard Cite

ObjectivesTo investigate if glucose levels influence seizure patterns.Materials and methodsIn a patient with RNS/NeuroPace implanted bi-temporally and type 1 diabetes mellitus, seizure event times and onset locations were matched to continuous tissue glucose.ResultsLeft focal seizure (LFS, n = 22) glucoses averaged 169 mg/dL, while right focal seizure (RFS, n = 23) glucoses averaged 131 mg/dL (p = 0.03). LFS occurred at mean time 17:02 while RFS occurred at 04:23. LFS spread to the contralateral side (n = 19) more than RFS (n = 2).ConclusionSeizure onset laterality and spread vary with glucose and time of seizure.

show abstract

Association between type 1 diabetes mellitus and risk of epilepsy: A meta-analysis of observational studies

Cited by 13 publications

References 20 publications

The Effect of Metformin in Experimentally Induced Animal Models of Epileptic Seizure

The Effect of Metformin in Experimentally Induced Animal Models of Epileptic Seizure

Drivers for the comorbidity of type 2 diabetes mellitus and epilepsy: A scoping review

Continuous monitoring devices and seizure patterns by glucose, time and lateralized seizure onset

Contact Info

Product

Resources

About