"Additional randomized, controlled trials that follow people over time are needed to confirm these findings, but these results are promising, since people with diabetes are at increased risk for developing epilepsy later in life," said study author Edy Kornelius, MD, PhD, of Chung Shan Medical University in Taichung, Taiwan, in a press release.
For the study, researchers analyzed US healthcare data from over 450,000 adults with type 2 diabetes who had begun treatment with either GLP-1 drugs or DPP-4 inhibitors, both used to manage diabetes and support weight loss. GLP-drugs included dulaglutide, liraglutide, and semaglutide, but not dual GLP-1 and GIP receptor agonist, tirzepatide, which became available after the study began. Participants were an average of 61 years old, and none had a prior diagnosis of epilepsy or seizure. Follow-up was at least five years.
Ultimately, 2.35% of patients taking GLP-1 medications developed epilepsy, whereas the same figure was true for 2.41% of those taking DPP-4 inhibitors. After accounting for factors that may influence epilepsy, such as age, high blood pressure, and cardiovascular disease, researchers found that those taking GLP-1 drugs were 16% less likely to develop epilepsy, with protective associations visible from the first year. Among all the drugs, semaglutide showed the strongest association.
"More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar. It should be noted that these findings do not imply that DPP-4 inhibitors are harmful in any way or that GLP-1 drugs are definitely beneficial for brain health,” said Kornelius.
Limitations to the findings include the study’s retrospective, observational design, as well as a lack of information on other factors that may influence epilepsy risk, like family medical history, genetic susceptibility, and alcohol use.
Sources: Science Daily, Neurology