Type 1 diabetes and epilepsy in childhood and adolescence: Do glutamic acid decarboxylase autoantibodies play a role? Data from the German/Austrian/Swiss/Luxembourgian DPV Registry

Pediatr Diabetes. 2020 Aug;21(5):766-773. doi: 10.1111/pedi.13034. Epub 2020 May 7.

Abstract

Aims: We aimed to analyze the relationship between epilepsy and glutamic acid decarboxylase autoantibodies (GADA) in patients with type 1 diabetes mellitus (T1DM) and the impact of GADA on demographic, clinical, and metabolic data in T1DM patients with epilepsy.

Methods: We searched for patients with T1DM ≤20 years and GADA measurements, and within this group for patients with epilepsy. We formed groups: T1DM + Epilepsy + GADA positive; T1DM + Epilepsy + GADA negative; T1DM + GADA positive; T1DM + GADA negative. We used logistic regression to analyze the relationship between epilepsy and GADA with odds ratio adjusted for sex, duration of diabetes (DOD), and age at diabetes onset (ADO). We used logistic regression with odds ratio adjusted for DOD and ADO onset using epilepsy as a dependent variable and GADA, HbA1c, ketoacidosis, severe hypoglycemia (SH), sex, celiac disease, and autoimmune thyroiditis as independent variables. We conducted regression analyses adjusted for sex, DOD, and ADO to analyze differences in clinical/metabolic parameters between the groups.

Results: Epilepsy was not more frequent in GADA-positive patients (GPP). Logistic regression including all patients with GADA measurements showed that hypoglycemia with coma (HC) correlated with epilepsy when compared to no SH. We found no differences in clinical and metabolic data between GPP and GADA-negative patients (GNP) with epilepsy. SH occurred more often in GPP with epilepsy in comparison to GPP without epilepsy. GNP with epilepsy had a higher rate of HC than GPP without epilepsy.

Conclusion: We found no relationship between epilepsy and GADA. A relationship between T1DM and epilepsy might be explainable by SH.

Keywords: children and adolescents; diabetes mellitus type 1; epilepsy; glutamic acid decarboxylase autoantibodies; severe hypoglycemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Austria / epidemiology
  • Autoantibodies / adverse effects
  • Autoantibodies / blood
  • Autoantibodies / physiology*
  • Child
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / immunology
  • Epilepsy / blood
  • Epilepsy / epidemiology*
  • Epilepsy / etiology
  • Female
  • Germany / epidemiology
  • Glutamate Decarboxylase / immunology
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / complications
  • Hypoglycemia / epidemiology
  • Luxembourg / epidemiology
  • Male
  • Risk Factors
  • Switzerland / epidemiology

Substances

  • Autoantibodies
  • Glutamate Decarboxylase