SGLT2 Inhibitors Linked to Lower Epilepsy Risk
Real-world cohort data show lower epilepsy risk vs DPP-4 inhibitors in older patients with type 2 diabetes
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By
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Kathryn Wighton
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April 7, 2026
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Clinical Scorecard: SGLT2 Inhibitors Linked to Lower Epilepsy Risk
At a Glance
| Category | Detail |
|---|
| Condition | Late-onset epilepsy and related conditions |
| Key Mechanisms | SGLT2 inhibitors associated with lower incidence of epilepsy and antiseizure medication initiation |
| Target Population | Patients aged 60 years and older with type 2 diabetes |
| Care Setting | Real-world cohort study |
Key Highlights
- SGLT2 inhibitors linked to 45% lower risk of late-onset epilepsy compared to DPP-4 inhibitors
- 62% lower risk of status epilepticus with SGLT2 inhibitors
- 37% lower risk of initiating antiseizure medications in SGLT2 group
- Significant differences observed across various demographics and comorbidities
- No significant differences in activities of daily living, falls, or all-cause mortality
Guideline-Based Recommendations
Diagnosis
- Monitor for late-onset epilepsy in older patients with diabetes
Management
- Consider SGLT2 inhibitors as a treatment option for older patients with type 2 diabetes
Monitoring & Follow-up
- Regular follow-up for neurological symptoms and medication adherence
Risks
- Potential for residual confounding and reliance on coded diagnoses
Patient & Prescribing Data
Older adults with type 2 diabetes
SGLT2 inhibitors may reduce the risk of epilepsy and related complications
Clinical Best Practices
- Evaluate the use of SGLT2 inhibitors in high-risk populations, such as those with prior stroke or dementia
- Monitor for initiation of antiseizure medications in patients starting SGLT2 inhibitors
References
