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Association of Epilepsy and Type 1 Diabetes Mellitus in Children and Adolescents: Is There an Increased Risk for Diabetic Ketoacidosis
The Journal of Pediatrics, 11/16/2011
Schober E et al. – Children and adolescents with diabetes mellitus show an increased prevalence of epileptic seizures. For unknown reasons, there is an association between epilepsy and diabetic ketoacidosis in children with type 1 diabetes mellitus.
Methods- The authors conducted an observational cohort study based on the Diabetes Patienten Verlaufsdokumentation database including data from 45 851 patients (52% male) with type 1 diabetes mellitus, age 13.9 ± 4.3 years (mean ± SD) and duration of diabetes mellitus 5.4 ± 4.2 years.
- The database was searched for the concomitant diagnosis of epilepsy or epileptic convulsions and for antiepileptic medication.
- A total of 705 patients with epilepsy were identified, giving a prevalence of 15.5 of 1000.
- A total of 375 patients were treated with antiepileptic medication, and 330 patients were without anticonvulsive therapy.
- Patients with epilepsy were younger at onset of diabetes mellitus and shorter than patients without epilepsy, and their weight and body mass index were comparable.
- No difference could be demonstrated for metabolic control, type of insulin treatment, insulin dose, and prevalence of B–cell specific autoantibodies.
- The frequency of severe hypoglycemia was lower in patients treated with antiepileptic medication.
- The risk for diabetic ketoacidosis was almost double in patients with epilepsy compared with patients with type 1 diabetes mellitus alone (P < .01).
