Association of Epilepsy and Type 1 Diabetes Mellitus in Children and Adolescents: Is There an Increased Risk for Diabetic Ketoacidosis?
Association of Epilepsy and Type 1 Diabetes Mellitus in Children and Adolescents: Is There an Increased Risk for Diabetic Ketoacidosis?
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DOI：
10.1016/j.jpeds.2011.09.054
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发表时间：
2012-04-01
影响因子：
5.1
通讯作者：
Holl, Reinhard
中科院分区：
文献类型：
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作者：
Schober, Edith;Otto, Klaus Peter;Holl, Reinhard
目的评估儿童和青少年糖尿病患者癫痫的患病率和可能的危险因素。研究设计我们进行了一项基于糖尿病患者Verlaufsdokumentation数据库的观察性队列研究，包括45 851例患者的数据（52%男性）1型糖尿病患者，年龄13.9 ± 4.3岁（平均值± SD），糖尿病病程5.4 ± 4.2年。数据库进行了搜索的伴随诊断癫痫或癫痫性惊厥和抗癫痫medication.Results共705例癫痫患者被确定，1000年的患病率为15.5。共有375例患者接受抗癫痫药物治疗，330例患者未接受抗惊厥治疗。癫痫患者在糖尿病发病时比无癫痫患者更年轻，身高更矮，体重和体重指数也相当。代谢控制、胰岛素治疗类型、胰岛素剂量和B细胞特异性自身抗体的患病率无差异。在接受抗癫痫药物治疗的患者中，严重低血糖的发生率较低。与单纯1型糖尿病患者相比，合并癫痫患者发生糖尿病酮症酸中毒的危险性几乎增加一倍（P <0.01）。1型糖尿病患儿癫痫与糖尿病酮症酸中毒之间存在相关性，原因不明。（J Pediatr 2012;160：662-6）。
Objective To estimate the prevalence of epilepsy and possible risk factors in children and adolescents with diabetes mellitus.Study design We conducted an observational cohort study based on the Diabetes Patienten Verlaufsdokumentation database including data from 45 851 patients (52% male) with type 1 diabetes mellitus, age 13.9 +/- 4.3 years (mean +/- SD) and duration of diabetes mellitus 5.4 +/- 4.2 years. The database was searched for the concomitant diagnosis of epilepsy or epileptic convulsions and for antiepileptic medication.Results A total of 705 patients with epilepsy were identified, giving a prevalence of 15.5 of 1000. A total of 375 patients were treated with antiepileptic medication, and 330 patients were without anticonvulsive therapy. Patients with epilepsy were younger at onset of diabetes mellitus and shorter than patients without epilepsy, and their weight and body mass index were comparable. No difference could be demonstrated for metabolic control, type of insulin treatment, insulin dose, and prevalence of B-cell specific autoantibodies. The frequency of severe hypoglycemia was lower in patients treated with antiepileptic medication. The risk for diabetic ketoacidosis was almost double in patients with epilepsy compared with patients with type 1 diabetes mellitus alone (P < .01).Conclusion Children and adolescents with diabetes mellitus show an increased prevalence of epileptic seizures. For unknown reasons, there is an association between epilepsy and diabetic ketoacidosis in children with type 1 diabetes mellitus. (J Pediatr 2012;160:662-6).