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Overrepresentation of epilepsy in children with type 1 diabetes is declining in a longitudinal population study in
Matti Sillanpää1,2, Maiju M Saarinen1,2,3, Tapani Rönnemaa4
1Department of Child Neurology, University of Turku and Turku University Hospital, Turku, Finland.
Insights
Children with type 1 diabetes have an increased risk of developing epilepsy. This risk, however, slowly declines over time, suggesting a dynamic relationship between type 1 diabetes and epilepsy incidence.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Epidemiology
Background:
- Type 1 diabetes is an autoimmune condition affecting children.
- Epilepsy is a neurological disorder characterized by recurrent seizures.
- The association between type 1 diabetes and epilepsy risk requires further investigation.
Purpose of the Study:
- To determine temporal changes in the risk of epilepsy among children diagnosed with type 1 diabetes.
- To analyze the incidence of epilepsy in relation to type 1 diabetes diagnosis over time.
Main Methods:
- Utilized data from the Finnish nationwide hospital register.
- Analyzed epilepsy incidence up to age 15 in children with prior type 1 diabetes compared to the general population.
- Employed negative binomial regression models for statistical analysis, identifying conditions via ICD-9/10 codes and epilepsy per ILAE guidelines.
Main Results:
- Children with type 1 diabetes exhibited a higher incidence rate of new-onset epilepsy (140 per 100,000 person-years) compared to controls (82 per 100,000 person-years).
- The excess risk of epilepsy diminished over time, with incidence rate ratios decreasing from 2.2 in the 1990-1993 birth cohort to 1.4 in the 1998-2000 birth cohort.
- A statistically significant interaction (P=0.033) was observed between type 1 diabetes and birth cohort, indicating a temporal decline in epilepsy risk.
Conclusions:
- Children with type 1 diabetes face an elevated risk of developing epilepsy.
- This increased risk is not static and shows a gradual decline over time.
- Further research is warranted to understand the underlying mechanisms driving this association.
Aim:
The aim was to determine temporal changes in increased risk of epilepsy among children with type 1 diabetes.
Methods:
The incidence of epilepsy up to age 15 in children with prior type 1 diabetes was analysed regarding the general Finnish child population using data from the Finnish nationwide hospital register. Type 1 diabetes and epilepsy were identified by the International Classification of Diseases 9th and 10th revision codes. Epilepsy was defined according to ILAE guidelines. The analyses were done using negative binomial regression models.
Results:
Preceding type 1 diabetes was diagnosed in 6162 (0.91%) of the 679 375 general children population. Incidence rate of new-onset epilepsy among children with type 1 diabetes was higher than in controls (140 vs 82 per 100 000 person-years at risk, respectively). The excess incidence diminished with time (P = 0.033 for diabetes to birth cohort interaction), from over twofold in birth cohort 1990-1993 [incidence rate ratio 2.2 (95% CI 1.7-2.9)] to 40% in birth cohort 1998-2000 [1.4 (95% CI 1.001-1.9)].
Conclusion:
In a population study setting, children with type 1 diabetes had an increased, but slowly declining risk of developing epilepsy. Future research may elucidate the underlying mechanisms.
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