A study has revealed a surprising finding linking diabetes drugs of the GLP-1 class (glucagon-like peptide-1 receptor agonists) to a reduced risk of epilepsy in patients with type 2 diabetes.
The findings, published in the journal Neurology, found that people who used GLP-1 drugs (such as semaglutide, liraglutide, and dulaglutide) showed a 16% reduction in the likelihood of developing epilepsy compared to those treated with another class of drugs (DPP-4 inhibitors, or "gliptins").
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Among the GLP-1 drugs included in the study, semaglutide (commercially known as Ozempic and Wegovi) was associated with the strongest potential protective effect against epilepsy.
The researchers stressed that the study does not prove a causal relationship, meaning it does not confirm that the drug is what causes the reduced risk, but rather shows a promising statistical correlation that needs explanation.
A research team from Chung Shan Medical University in Taiwan, led by Dr. Eddie Cornelius, analyzed the electronic health data of 452,766 adults with type 2 diabetes in the United States. None of the participants had a history of epilepsy. A group that started treatment with GLP-1 inhibitors was compared to another group that started treatment with DPP-4 inhibitors, and all participants were followed for at least five years.
During the study, 1670 new cases of epilepsy were recorded in the GLP-1 group (2.35%), while 1886 new cases of epilepsy were recorded in the DPP-4 inhibitor group (2.41%).
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After statistically adjusting for several potential influencing factors (such as age, high blood pressure, and cardiovascular disease), the association with a 16% reduction in risk remained in favor of the GLP-1 drug group.
Dr. Cornelius commented, "These findings support the theory that GLP-1 drugs may have neurological benefits beyond simply controlling blood sugar levels... These results are promising, especially given that people with diabetes are at increased risk of developing epilepsy later in life." He added that this discovery could be significant because "many people do not respond to current epilepsy medications, so finding ways to reduce this risk is crucial."
Despite the excitement surrounding these findings, the researchers cautioned about several key limitations:
Study design: It relied on existing health data (a retrospective observational study), which means it is less reliable than randomized controlled trials specifically designed to test a hypothesis.
Data gaps: The study lacked vital information that could affect the risk of epilepsy, such as family history of the disease, genetic predisposition, and alcohol use.
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Potential confounding factors: Factors such as the cost of treatment, insurance coverage, and the progression of the patient's diabetes may have played a role in the physician's choice of medication, potentially creating systematic differences between the two groups that were not fully measured.
New drug not included: Terzepatide (commercially known as Mongaro and Zippond) was not included in the analysis because it became available on the market after the start of the study data collection period. Therefore, these results do not apply to it, and it cannot be concluded whether it would have a similar effect.
This study represents a strong initial indication that opens a new avenue for research into the potential neurological benefits of common GLP-1 medications. However, there is still a long way to go before definitive confirmation is achieved. As the authors emphasized, carefully designed randomized controlled trials that follow individuals over time are urgently needed to confirm this association and understand its mechanism.
Patients should not change their prescribed medications based on these preliminary results, and any questions should be discussed with their treating physicians.
