In 2006, Irish Health published an article on research linking epiliepsy and diabetes http://www.irishhealth.com/article.html?id=8906 

This research found that the onset of epilepsy in young adulthood increased the risk of developing Type I Diabetes.  Thus, “the researchers suggested that it is possible that some people with type 1 diabetes to develop seizures only in response to low blood sugar or have unrecognised epilepsy, with only occasional spontaneous seizures”. 

This co-morbid group often fall within the category of uncontrolled or difficult to control epilepsy because the AED’s are simply not doing the job.  AED’s may increase the threshold at which a person has a seizure but they do not stop the seizures.  My question is this…is it possible that the AED’s are treating the wrong symptoms for this group because the seizures are due to low glucose within the brain rather than electrical impulses? 

I refer to another key piece of research that has found that Type II medication (Metformine) is proving to be successful in controlling epilepsy http://www.accessibility.com.au/news/diabetes-drug-may-hold-potential-as-treatment-for-epilepsy

Is it possible that this type of drug assists in maintaining the glucose levels within the brain rather than treating the electrical impulses?    The two disciplines of endocrinology and neurology tend not to cross paths and patients with the two conditions receive separate treatment regardless of the clear link between the two disorders. 

As far as I am aware, medical professionals would not be able to conclusively determine the difference between an epileptic seizure or a hypoglyaecmic seizure unless the person is being monitored by an EEG whilst a seizure is occuring - a difficult thing to do for many.  Hypoglyaecmic seizures are not epileptic seizures.  Someone experiencing hypoglyaecmia may not experience the full effects for hours afterwards and a hypo may not always result in serious side effects such as coma or seizures.  Another difficulty in determining a hypoglyecmic seizure is that a blood test provides an indication of blood sugar levels within the body but does not indicate the level of glucose within the brain. 

I suspect that some of this co-morbid group are not really co-mordid and may be misdiagnosed with Epilepsy as a result of hypoglycaemic seizures and worse still, put on a variety of relatively ineffective AED’s that merely increase the threshold at which a seizure will occur.  However, seizures will still occur due to diabetes which may make it likely that the person is treated with more AED’s or that the AED’s are continually changed which causes more difficultly for the person being treated. 

As far as I am aware, this topic is under researched and more is required urgently!  Human trials are needed to deteremine the types of medications that are effective for this significant group.  Metformine is a good start.  There should be a review of such patients by Neurologist to determine any misdiagnosis and awareness needs to be raised about this issue.

Until the links between epilepsy and diabetes is further investigated, this group will continue to suffer due to ineffective treatments that have a huge impact on their lives and the lives of their loved ones.