Glucose-lowering medications can reduce the risk of developing epilepsy.

Glucose-lowering medications can reduce the risk of developing epilepsy.

Summary of a study on diabetes and epilepsy

A preliminary study of people with diabetes suggests that use of blood sugar-lowering GLP-1 drugs may be associated with a lower risk of developing epilepsy. The study was conducted on December 10, 2025Neurology®, the medical journal of the American Academy of Neurology. GLP-1 drugs are used to treat diabetes and weight loss.

Key findings of the study

The study does not prove that GLP-1 drugs reduce the risk of epilepsy; it merely shows an association.

Additional randomized, controlled trials that follow people over time are needed to confirm these results. However, these results are promising because People with diabetes have an increased risk of developing epilepsy later in life. Epilepsy can have many physical, psychological and social consequences, and many people do not respond to currently available medications. Therefore, it is crucial to find ways to reduce this risk.

Edy Kornelius, MD, PhD, study author at Chung Shan Medical University in Taichung, Taiwan

Study structure

For the study, researchers examined a U.S. health database of adults who had type 2 diabetes and were taking either a GLP-1 drug or another drug known as dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors or gliptins). Participants had no prior diagnosis of epilepsy or seizures. The GLP-1 drugs considered in the study included dulaglutide, liraglutide and Semaglutide.

The 452,766 participants had an average age of 61 years. Half took the GLP-1 drugs and the other half took the DPP-4 inhibitors. They were followed for at least five years. During this time, 1,670 people taking GLP-1 drugs developed epilepsy (2.35%), compared to 1,886 people taking DPP-4 inhibitors (2.41%).

Results of the study

After the researchers took into account other factors that could influence the risk of epilepsy, such as age, high blood pressure and cardiovascular disease, they found that people taking GLP-1 drugs had 16% lower odds of developing epilepsy than people taking DPP-4 inhibitors.

When looking at each drug, the researchers found that the association with a lower risk of epilepsy was strongest with semaglutide.

“More research is needed, but these results support the theory that GLP-1 drugs may have neurological benefits beyond blood sugar regulation,” Kornelius said. "It should be noted, however, that these results do not imply that DPP-4 inhibitors are in any way harmful or that GLP-1 drugs are definitely beneficial for brain health."

Limitations of the study

Kornelius explained that tirzepatide, a dual GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist, was not included in the study because it was introduced after the start of the study period. Therefore, the results may not apply to tirzepatide.

In addition to the limitations of the retrospective, observational study design, the study has other limitations. Researchers had no information about other factors that might influence the risk of epilepsy, such as family history, genetic susceptibility or alcohol use. It is also possible that other factors such as cost, insurance restrictions, or the severity of the patient's diabetes could influence which drug was prescribed, which could lead to differences between the two groups.

The study was supported by Chung Shan Medical University Hospital.

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