Association Between Hyperglycemia and Epilepsy: From Clinical Implication to Therapeutics

Epilepsy and hyperglycemia are significant pathologies that are increasingly recognized to have an interlinked relationship. Epidemiological data highlights the growing prevalence of concurrent diabetes mellitus (DM) and epilepsy, emphasizing the need for tailored management strategies. Therefore, this study explores the complex association between hyperglycemia (particularly DM) and epilepsy. The Google Scholar, PubMed (NIH), CDC and WHO databases were searched using an advanced search feature manually through the second week of April 2024 for Journal articles, books and book chapters were manually searched under all languages without filter restrictions. The keywords used for the search are given below. This review delves into the pathogenesis of hyperglycemia-induced changes in brain function, including alterations in neurotransmitter activity, electrolyte imbalances and effects on neuronal excitability. The coexistence of DM and epilepsy presents clinical challenges, as certain antiepileptic medications can impact glycemic control and vice versa. The review examines the epidemiology of these coexisting conditions, focusing on risk factors, age of onset and potential comorbidities. The intricate pathways linking hyperglycemia to seizures, including the role of glutamate and ionotropic receptors, are dissected, shedding light on the mechanisms behind epileptic episodes in DM patients. This study highlights the vulnerability to seizures in T1DM patients due to cerebrovascular dysfunctions and altered seizure thresholds in specific brain structures. Furthermore, the management approaches for these comorbid conditions are discussed, encompassing non-pharmacological interventions such as lifestyle modifications and pharmacological treatments targeting both epilepsy and hyperglycemia. This comprehensive review synthesizes current knowledge on the intricate relationship between hyperglycemia and epilepsy in DM patients. The elucidation of underlying mechanisms and the development of effective management strategies are crucial to improving clinical outcomes in this growing patient population. Further research is needed to understand the intricacies of the connection and to improve treatment procedures for those who have DM and epilepsy.