Diabetic hyperglycemia is associated with the severity of epileptic seizures in adults

Epileptic seizures in diabetic hyperglycemia (DH) patients are not uncommon in clinical practice. Although there have been reports suggesting an association, most were limited case studies. The role of DH in the severity and recurrence of epileptic seizures remains unclear. We thus conducted a prospective comparative study of newly diagnosed unprovoked seizures in adult patients, with and without DH, from 2000 to 2004. Seizure semiology and severity were studied and all subjects were followed-up for 2 years to evaluate seizure recurrence. Forty-one patients in the DH and 70 patients in the non-DH group were recruited. Seizure clustering in initial presentation (63%) and in recurrence (78.6%) in the DH group was significantly higher than that in the non-DH group (38.5 and 41.4%) (p < 0.05). In the DH group, the HbA1c at first seizure was significantly higher in patients with seizure recurrence than in those without (11.8% vs. 8.6%, p < 0.05). Patients with poor glycemic control (HbA1c >9%) had significantly higher risk of seizure recurrence (44.8% vs. 8.3%) and clustering (79.3% vs. 25%) (p < 0.05). In conclusion, DH might aggravate epileptic seizures. Severe seizures might be associated with recurrent seizures in patients with DH. DH should be investigated in adult patients with newly diagnosed epileptic seizures and aggressive blood sugar control might benefit seizure management in patients with DH.