Type 1 diabetes can lead to seizures, primarily through significant fluctuations in blood sugar levels. Understanding this connection is important for individuals managing type 1 diabetes and their support networks. While not every blood sugar imbalance results in a seizure, severe instances can disrupt normal brain function.
Hypoglycemia and Seizures
The most frequent cause of seizures in individuals with type 1 diabetes is severe hypoglycemia. The brain relies almost exclusively on glucose for energy, and when its supply becomes insufficient, normal neurological function is impaired. As glucose levels drop, brain cells begin to malfunction, leading to a cascade of symptoms that can progress to a seizure.
Initially, mild hypoglycemia may cause symptoms such as shakiness, dizziness, and sweating. However, if blood sugar continues to fall, the brain’s energy deprivation intensifies. This can result in confusion, disorientation, slurred speech, and eventually, a loss of consciousness and seizures.
Severe hypoglycemia can also trigger the release of stress hormones like adrenaline and cortisol, further disrupting brain activity and contributing to seizure onset. While seizures from hypoglycemia are a serious medical event, prompt treatment to restore blood glucose levels can often reverse the effects.
Other Diabetes-Related Factors
Beyond severe hypoglycemia, other diabetes-related conditions can increase seizure risk. Diabetic Ketoacidosis (DKA), a serious complication of type 1 diabetes, involves high blood sugar, the presence of ketones, and metabolic acidosis. The extreme metabolic imbalances, including acidosis and dehydration, can affect brain function and potentially trigger seizures.
Severe hyperglycemia, even without ketoacidosis, can also increase the excitability of nerve cells and lead to seizures. This is particularly true in cases of hyperosmolar hyperglycemic state (HHS), which involves extremely high blood sugar levels and severe dehydration. Additionally, severe electrolyte imbalances such as hyponatremia (low sodium) or hypernatremia (high sodium), which can occur in extreme cases of diabetes complications, can also provoke seizures due to their impact on brain cell function.
Responding to a Seizure
If someone with type 1 diabetes experiences a seizure, protect the individual from injury by moving any nearby objects. Gently lay the person on their side to help them breathe easily and prevent choking, and place something soft under their head. It is important not to restrain the person or put anything in their mouth.
Once the immediate safety measures are in place, check their blood sugar levels. If the seizure is due to severe low blood sugar and the person is unconscious or unable to swallow, administer emergency glucagon. Glucagon is a hormone that raises blood sugar by prompting the liver to release stored glucose. After administering glucagon, turn the person onto their side, as glucagon can cause nausea and vomiting. Emergency services should be called immediately if the seizure lasts longer than 5 minutes, if it is their first seizure, if they have difficulty breathing afterward, or if they sustain an injury.
Preventing Seizure Risk
Proactive management of type 1 diabetes minimizes the risk of severe blood sugar fluctuations that can lead to seizures. Regular blood glucose monitoring, including the use of continuous glucose monitors (CGMs), provides real-time data that helps individuals and healthcare providers identify trends and adjust insulin dosing. CGMs can alert users to dangerously low blood sugar levels, offering an early warning before a severe hypoglycemic event occurs.
Maintaining consistent meal timing and appropriate insulin dosing are also important strategies. Understanding how exercise impacts blood sugar and adjusting insulin or carbohydrate intake accordingly can prevent unexpected drops. Developing a plan for managing sick days, when blood sugar can be particularly unpredictable, is also beneficial. Educating both individuals with type 1 diabetes and their support network about recognizing and promptly treating hypoglycemia is essential, as early intervention can prevent it from progressing to a seizure.