What Glucose Level Causes Seizures?
by IDS Director of Intensive Diabetes Management, Tavia Vital
A newly published study by Urushidani S, et al, looked to identify the frequency that hypoglycemia is associated with seizure occurrence in the Emergency Department in a retrospective data review in Japan.
What they found is intriguing.
Of 380 patients who needed Emergency Medical Team assistance for hypoglycemia, only 5% (N of 19) had a seizure. Of those with seizures, one person received oral glucose and the rest received IV glucose treatment. Seizures resolved with glucose treatment.
In the group of people who experienced seizures, 8 had T1D, 8 had T2D, and 3 did not have diabetes. Of the 3 without diabetes, 2 had alcoholism, and 1 was post gastrectomy (surgery to remove part or all of the stomach).
In the people living with diabetes who had a seizure induced by hypoglycemia (N of 16), the following additional medical diagnoses were listed in the medical record: one was pregnant, 2 had kidney disease, 2 had Chronic Heart Failure, one had Chronic Obstructive Pulmonary Disease, 2 had infections. None of the 19 had a medical history of, or any new diagnosis related to, Epilepsy.
Of the 19 patients who experienced seizure, 16 (84.2%) were unconscious upon the EMT´s arrival compared to 273 (74%) out of 380 people who did not experience seizure with hypoglycemia. Additionally, 2.4% (N of 9) of patients who did not experience seizures did experience hemiparesis (likely a temporary symptom of severe hypoglycemia).
The range in initial glucose levels was, for those with seizure, 15-55 mg/dL with an Interquartile Range of 23-46 mg/dL and without seizure 24-45 mg/dL.
The study notes a limitation in the variability with glucose-checking methods and timing. This means it is possible in some cases there was a lower glucose prior to the initial glucose level recorded by the Emergency Medical Team (EMT). For example, it is possible an initial glucose check by the EMTs in the 50s or 60s started off at a much lower level in those who had a seizure, but some type of oral treatment was starting to take effect by the time the EMT arrived on scene to take a glucose level.
Unfortunately, this study did not find the answer to a common question people living with diabetes have, ¨What glucose level can cause a seizure?¨
Other studies also show a range of glucose levels associated with seizure, no seizure, symptoms of hypoglycemia and minimal to no symptoms of hypoglycemia. For the time being, it seems it is not simply a glucose number that can trigger a seizure in some people. More research is needed in this area.
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