Research in Taiwan suggests that children and adolescents who have type 1 diabetes* are almost three times as likely to develop epilepsy as those without type 1 diabetes.Type 1 diabetes is an ‘autoimmune’ condition, whereby the body’s immune system mistakenly attacks some of its own cells. There is increasing evidence that some forms of epilepsy have an autoimmune basis, and also that a person who has one autoimmune condition is at an increased risk of developing another. Although past investigations have been relatively limited, they have suggested a particularly strong association between type 1 diabetes and the development of epilepsy, which requires further investigation.For the current study, led by the China Medical University Children’s Hospital, the researchers examined data from the Taiwan National Health Insurance Research Database (NHIRD), which includes almost all residents in Taiwan (this was 23 million in 1998). They found 2,568 children and adolescents aged 18 and under who had been diagnosed with new-onset type 1 diabetes between 1 January 2000 and 31 December 2009, and they also identified 25,680 youngsters without diabetes who served as a control or comparison group. All subjects’ data was tracked for a defined follow-up period, to see if they had developed epilepsy in this time.It is important to note that the children in the control group were on average slightly older, and slightly less likely to have an intellectual disability or prior epilepsy, than those in the type 1 diabetes group. The team would have to account for these factors, and others, in their analyses, to avoid skewing the results (see below).During follow-up, the researchers discovered 59 cases of new-onset epilepsy amongst the children with type 1 diabetes, and 181 cases of new-onset epilepsy in the comparison group. After they had accounted for differences in age, gender, urban versus country dwelling, prior epilepsy, intellectual disabilities, low birth weight and head injury, the risk of epilepsy in the type 1 diabetes group was found to be 2.84-fold higher than in the control group. Amongst the children with diabetes, those who experienced a lot of hypoglycaemic episodes were shown to be at a significantly increased risk of developing epilepsy (16.5 x that of the control group) compared to those who did not have many hypoglycaemic episodes (their risk was found to be 2.67 x that of the control group).A lot more research is needed to establish the mechanisms that underlie the link between type 1 diabetes and epilepsy, but according to Lead Author, Dr Chu, these findings support the hypothesis that “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 consequences.”The findings of this study are very important and they further highlight the need for good blood glucose control in people with diabetes. An increased awareness of the risk of epilepsy amongst young people with type 1 diabetes will also help specialists in both fields to reach accurate diagnoses and appropriate care plans. Further insight into the underlying mechanisms could be valuable in identifying new epilepsy treatments, and perhaps even preventative strategies.Read the original scientific paper in Diabetologia.Click here for more articles about epilepsy in children.*For information about type 1 diabetes, please visit https://jdrf.org.uk/.