Antidiabetics have Beneficial Effects on Epileptic Seizures in Diabetic Patients: A Narrative Review

Abstract

Several studies have reported the association of diabetes mellitus with epilepsy. With respect to the management of diabetes–epilepsy patients, these studies pointed out the beneficial effects of the ketogenic diet. Ketogenic diets may have antiepileptic properties as the utilization of ketone bodies in the brain instead of glucose delays or inhibits the degradation of γ-aminobutyric acid (GABA) transaminase, and thereby enhances the concentration of GABA. By restoring normal intracerebral GABA levels and reducing the cerebral inflammation linked to epilepsy, metformin is useful in preventing seizures. Sitagliptin has a positive impact on epilepsy by acting as an antioxidant and restoring normal GABA levels. Weight gain is a well-known side effect of anti-seizure medications. Sodium valproate can cause dyslipidemia and inhibits glucose transporter-1 in the brain, putting patients with epilepsy and diabetes at risk of developing atherosclerosis. Cellular stress in diabetes and epilepsy induces autophagy and activates lipid peroxidation, which leads to ferroptosis. It’s worth looking at how ferroptosis and autophagy contribute to the etiology of diabetes and epilepsy, as well as how antiepileptics and antidiabetics alter these pathological processes. Therefore, it was worth performing a narrative-review on the effects of antiepileptics on diabetes, the effect of antidiabetics on epilepsy, as well the net results of antiepileptic–antidiabetic interactions in those patients.

Keywords

• Epilepsy
• Antidiabetes
• Antiepileptics
• Autophagy
• Ferroptosis

Project Number

01

Antidiabetics have Beneficial Effects on Epileptic Seizures in Diabetic Patients: A Narrative Review

Abstract

Several studies have reported the association of diabetes mellitus with epilepsy. With respect to ‎the management of diabetes–epilepsy patients, these studies pointed out the beneficial effects of ‎the ketogenic diet. Ketogenic diets may have antiepileptic properties as the utilization of ketone ‎bodies in the brain instead of glucose delays or inhibits the degradation of γ-aminobutyric acid ‎‎(GABA) transaminase, and thereby enhances the concentration of GABA. By restoring normal ‎intracerebral GABA levels and reducing the cerebral inflammation linked to epilepsy, metformin ‎is useful in preventing seizures. Sitagliptin is one of the dipeptidyl dipeptidase-4 inhibitors, ‎which have a positive impact on epilepsy in experimental animal models with pentylenetetrazole-‎induced seizures, by reducing reactive oxygen species, (antioxidant effect), normalization of ‎GABA level, suppression of neuroinflammation (autophagy) and reduced neuronal damage ‎‎(antiapoptotic effect). Weight gain is a well-known side effect of anti-seizure medications. ‎Sodium valproate can cause dyslipidemia and inhibit glucose transporter-1 in the brain, putting ‎patients with epilepsy and diabetes at risk of developing atherosclerosis. It's worth looking at ‎how ferroptosis and autophagy contribute to the etiology of diabetes and epilepsy, as well as ‎how antiepileptics and antidiabetics alter these pathological processes. Therefore, it was worth ‎performing a narrative-review on the effects of antiepileptics on diabetes, the effect of ‎antidiabetics on epilepsy, as well the net results of antiepileptic–antidiabetic interactions in those ‎patients.‎

Keywords

• Epilepsy
• Antidiabetes
• Antiepileptics
• Autophagy
• Ferroptosis

Supporting Institution

Al-Kut University College

Project Number

01

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