I-Ching Chou1,2, Chung-Hsing Wang1,3,4, Wei-De Lin5,6, Fuu-Jen Tsai1,3,5,7,8, Che-Chen Lin4,9, Chia-Hung Kao10,11. 1. Department of Pediatric Neurology, China Medical University Children's Hospital, Taichung, Taiwan. 2. Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 3. Department of Pediatric Genetics, China Medical University Children's Hospital, Taichung, Taiwan. 4. School of Medicine, China Medical University, Taichung, Taiwan. 5. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. 6. School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan. 7. School of Chinese Medicine, China Medical University, Taichung, Taiwan. 8. Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan. 9. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 10. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan. d10040@mail.cmuh.org.tw. 11. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. d10040@mail.cmuh.org.tw.
Abstract
AIMS/HYPOTHESIS: Type 1 diabetes mellitus is a major public health problem of increasing global concern, with potential neurological complications. A possible association exists between type 1 diabetes and subsequent epilepsy. This study evaluated the relationship between type 1 diabetes and epilepsy in Taiwan. METHODS: Claims data from the Taiwan National Health Insurance Research Database were used to conduct retrospective cohort analyses. The study cohort contained 2568 patients with type 1 diabetes, each of whom was frequency-matched by sex, urbanisation of residence area and index year with ten patients without type 1 diabetes. Cox proportional hazard regression analysis was conducted to estimate the effects of type 1 diabetes on epilepsy risk. RESULTS: In patients with type 1 diabetes, the risk of developing epilepsy was significantly higher than that in patients without type 1 diabetes (p < 0.0001 for logrank test). After adjustment for potential confounders, the type 1 diabetes cohort was 2.84 times as likely to develop epilepsy than the control cohort was (HR 2.84 [95% CI 2.11, 3.83]). CONCLUSIONS/ INTERPRETATION: Patients with type 1 diabetes are at an increased risk of developing epilepsy. Metabolic abnormalities of type 1 diabetes, such as hyperglycaemia and hypoglycaemia, may have a damaging effect on the central nervous system and be associated with significant long-term neurological sequelae. The causative factors between type 1 diabetes and the increased risk of epilepsy require further investigation.
AIMS/HYPOTHESIS: Type 1 diabetes mellitus is a major public health problem of increasing global concern, with potential neurological complications. A possible association exists between type 1 diabetes and subsequent epilepsy. This study evaluated the relationship between type 1 diabetes and epilepsy in Taiwan. METHODS: Claims data from the Taiwan National Health Insurance Research Database were used to conduct retrospective cohort analyses. The study cohort contained 2568 patients with type 1 diabetes, each of whom was frequency-matched by sex, urbanisation of residence area and index year with ten patients without type 1 diabetes. Cox proportional hazard regression analysis was conducted to estimate the effects of type 1 diabetes on epilepsy risk. RESULTS: In patients with type 1 diabetes, the risk of developing epilepsy was significantly higher than that in patients without type 1 diabetes (p < 0.0001 for logrank test). After adjustment for potential confounders, the type 1 diabetes cohort was 2.84 times as likely to develop epilepsy than the control cohort was (HR 2.84 [95% CI 2.11, 3.83]). CONCLUSIONS/ INTERPRETATION:Patients with type 1 diabetes are at an increased risk of developing epilepsy. Metabolic abnormalities of type 1 diabetes, such as hyperglycaemia and hypoglycaemia, may have a damaging effect on the central nervous system and be associated with significant long-term neurological sequelae. The causative factors between type 1 diabetes and the increased risk of epilepsy require further investigation.
Entities:
Keywords:
Epilepsy; National Health Insurance Research Database; Type 1 diabetes
Authors: Janet Silverstein; Georgeanna Klingensmith; Kenneth Copeland; Leslie Plotnick; Francine Kaufman; Lori Laffel; Larry Deeb; Margaret Grey; Barbara Anderson; Lea Ann Holzmeister; Nathaniel Clark Journal: Diabetes Care Date: 2005-01 Impact factor: 19.112
Authors: S Knight; E Northam; S Donath; A Gardner; N Harkin; C Taplin; P Joy; F J Cameron; G R Ambler Journal: Diabetologia Date: 2008-11-06 Impact factor: 10.122