In a large real-world cohort study of more than 1.4 million older adults with type 2 diabetes, use of sodium-glucose cotransporter 2 inhibitors was associated with significantly lower risks of late-onset epilepsy, status epilepticus, and initiation of antiseizure medications compared with dipeptidyl peptidase-4 inhibitors, with consistent findings across multiple sensitivity and subgroup analyses. The observed risk reduction was most pronounced in patients with prior stroke or dementia, supporting a potential neuroprotective, etiology-specific effect of sodium-glucose cotransporter 2 inhibitor beyond glycemic control, although no benefit was seen in epilepsy related to traumatic brain injury or brain tumors.

Source: Epilepsia