To investigate the association between SGLT2 inhibitors and the risk of late-onset epilepsy, status epilepticus, and initiation of antiseizure medications in older patients with type 2 diabetes.
Approach:
Key Findings:
SGLT2 inhibitors were associated with a 45% lower risk of late-onset epilepsy (0.20% vs 0.42%).
Lower rates of status epilepticus were observed with SGLT2 inhibitors (0.02% vs 0.07%; 62% lower risk).
Initiation of antiseizure medications was 37% lower in patients using SGLT2 inhibitors (1.33% vs 2.33%).
Subgroup analyses indicated lower risks across various demographics and comorbidities.
Interpretation:
SGLT2 inhibitors may provide a protective effect against late-onset epilepsy and related complications in older patients with type 2 diabetes, although causality cannot be established.
Limitations:
Reliance on coded diagnoses for identifying epilepsy.
Lack of data on medication dosing and adherence.
Possibility of residual confounding.
Absence of detailed neurologic information such as neuroimaging or electrophysiologic measures.
Conclusion:
SGLT2 inhibitor use is associated with significantly lower risks of late-onset epilepsy, status epilepticus, and initiation of antiseizure medications in older adults with type 2 diabetes.
