Risk for Epilepsy Reduced With GLP-1 Receptor Agonist Use in Type 2 Diabetes

MONDAY, Dec. 15, 2025 (HealthDay News) -- For adults with type 2 diabetes mellitus (T2DM), glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy is associated with a reduced risk for epilepsy, according to a study published online Dec. 10 in Neurology.Ching-Yang Cheng, M.D., from Chung Shan Medical University in Taichung, Taiwan, and colleagues conducted a retrospective cohort study using the TriNetX network from 2015 to 2023 for adults with T2DM who were new users of GLP-1 RAs or dipeptidyl peptidase-4 inhibitors (DPP-4is) to examine the risk for incident epilepsy. After propensity score matching, 452,766 patients were included (226,383 in each group).The researchers found that 1,670 and 1,886 patients in the GLP-1 RA and DPP4i groups, respectively, developed epilepsy during follow-up, corresponding to a cumulative incidence of 2.35 and 2.41 percent, respectively. GLP-1 RA use was associated with significantly lower epilepsy risk (hazard ratio, 0.84), with protective associations seen at one, three, and five years (hazard ratios, 0.71, 0.81, and 0.82, respectively). Semaglutide showed the strongest association among individual agents (hazard ratio, 0.68). Across major subgroups, including age and sex, the results were consistent. Excluding patients with overlapping or switching exposure yielded similar findings in sensitivity analyses (hazard ratio, 0.71)."More research is needed, but these findings support the theory that GLP-1 drugs may have neurological benefits beyond controlling blood sugar," coauthor Edy Kornelius, M.D., Ph.D., also from Chung Shan Medical University, said in a statement. "It should be noted that these findings do not imply that DPP-4 inhibitors are harmful in any way or that GLP-1 drugs are definitely beneficial for brain health."Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter