MECHANISMS IN ENDOCRINOLOGY: Seizures and type 1 diabetes mellitus: current state of knowledge

Abstract

In this review, we will try to analyze the possible coexistence between epilepsy or seizures and type 1 diabetes mellitus (T1DM), in order to establish if there is more than a casual association, and to investigate possible mechanisms underlying this link. Anti-glutamic acid decarboxylase antibodies (GAD-Abs) have been associated with T1DM and a great number of neurological diseases such as epilepsy. Epilepsy can be a feature of a large variety of autoimmune or inflammatory disorders. GAD-Abs can have a role at the basis of the possible link between epilepsy and T1DM, although their real pathogenetic mechanism in neurological diseases is still unknown. Metabolic conditions such as hypoglycemia and hyperglycemia, common problems in diabetic patients, may be also implicated, even if their underlying mechanism is minimally understood.

Streptozotocin diabetic mice display depressive-like behavior and alterations in the structure, neurotransmission and plasticity of medial prefrontal cortex interneurons

“…This overexcitation may result in an increased risk of developing seizures. Although we do not know whether the animals in our model are more prone to seizures, there is solid evidence for an association between seizures and type 1 diabetes mellitus and epilepsy can be a feature of diabetic patients (Verrotti et al, 2012;Yun and Xuefeng, 2013). The available evidence suggests that specific pathogenic antibodies can react with neuronal antigens in a subpopulation of diabetic patients.…”

“…These antibodies can have a role on the possible link between epilepsy and T1DM, although their real pathogenetic mechanism in neurological disorders is still unknown. Metabolic conditions such as hypoglycemia and hyperglycemia, common problems in diabetic patients, may be also implicated, even if their underlying mechanism is minimally understood (Verrotti et al, 2012).…”

Type 1 diabetes mellitus and risk of incident epilepsy: a population-based, open-cohort study

“…depression) complications of the disease. The potential association between type 1 diabetes and neurological conditions, in particular epilepsy, has recently received intense scrutiny [2][3][4]. Epidemiological evidence suggests that the prevalence of type 1 diabetes in patients with idiopathic generalised epilepsies [5] and the prevalence of epilepsyrelated disorders in patients with type 1 diabetes may both be increased [6].…”

Long-term metabolic alterations in a febrile seizure model

“…The coexistence of seizures or epilepsy and type 1 diabetes has been observed in epidemiological surveys [8]. Furthermore, decreased blood glucose levels were detected in the kainite-induced epilepsy model, and blood glucose levels modulate seizure sensitivity [9].…”