Recent studies confirm that maternal diabetes during pregnancy elevates the risk of epilepsy in children, with type 1 and type 2 diabetes showing the strongest associations up to 30-40% higher hazard ratios after adjustments.
A 2026 retrospective cohort analysis of over 2.3 million births found prenatal exposure to maternal hyperglycemia contributes via metabolic and inflammatory pathways, though absolute risks stay low and good management mitigates threats. While the medical community has long understood the risks of birth defects and metabolic issues, the focus is now shifting toward the “intrauterine environment” as a primer for neurodevelopmental disorders.
Experts emphasised that the association should not trigger panic but it does reinforce the need for tighter monitoring and early intervention.
The brain–glucose connection
Dr Isha Wadhawan, Attending Consultant in Obstetrics & Gynaecology at Fortis Hospital (Faridabad) said that elevated blood sugar during pregnancy can affect the developing brain during critical windows.
“High blood sugar levels during crucial phases of fetal development may alter brain structure and function, potentially increasing susceptibility to seizures,” she said. Inflammation and oxidative stress linked to diabetes may also affect fetal brain health, she added.
Dr Ashok M N, Consultant in Internal Medicine & Diabetology at SPARSH Hospital (Bengaluru) said that diabetes in pregnancy is more than just elevated blood glucose. “It represents a complex hormonal and inflammatory state,” he said. When a mother has persistent hyperglycaemia, excess glucose crosses the placenta, prompting the fetus to produce high levels of insulin. This altered metabolic state may influence brain maturation, particularly when blood sugar fluctuates significantly.
Scientific literature has increasingly pointed to a link between maternal diabetes and long-term neurological outcomes, including a raised risk of epilepsy in children.
Dr Minal Kekatpure, Senior Consultant and Paediatric Neurologist at Narayana Health City (Bengaluru) said that children born to mothers with Type 1 or Type 2 diabetes may face a 30–40% higher relative risk of epilepsy, while gestational diabetes carries a lower but still notable risk.
One key mechanism, she explained, is inflammation. “High maternal glucose levels can create a pro-inflammatory environment in the placenta. Early-life inflammation can prime brain circuits for hyperexcitability which is the hallmark of epilepsy.”
Another concern is neonatal hypoglycaemia — a sharp drop in a newborn’s blood sugar after delivery. “Infants of diabetic mothers are prone to significant glucose dips shortly after birth. Severe cases can trigger acute seizures and possibly leave long-term changes in brain tissue,” Dr Kekatpure said.
Critical windows of brain development
The fetus undergoes rapid brain growth, especially during the second and third trimesters. Dr Mitul Gupta, Senior Consultant in Obstetrics and Gynaecology at Cocoon Hospital (Jaipur) stresses that sustained high blood glucose can cross the placenta and influence these delicate developmental stages.
“Neuronal growth and connectivity are sensitive to glucose fluctuations, oxidative stress and inflammatory changes,” he said. If blood sugar is poorly controlled, research suggests there may be a higher risk of neurodevelopmental conditions, including seizure disorders.
Also, early pregnancy exposure is particularly significant. Dr Kekatpure highlighted that first-trimester metabolic disturbances and epigenetic changes may lower a child’s seizure threshold in the long term.
However, all four specialists underline that the absolute risk of epilepsy remains relatively low. “This does not mean that every baby born to a diabetic mother will develop epilepsy,” Dr Wadhawan said. “With proper diabetes management, many potential complications can be significantly reduced.”
Prevention over fear: Managing the absolute risk
The consensus among experts is clear: careful glucose control before and during pregnancy is the most effective way to reduce risks.
Dr Ashok emphasised early screening for gestational diabetes through routine testing, tight glycaemic monitoring, continuous glucose tracking where needed, personalised dietary guidance and timely insulin therapy. Stabilising maternal blood sugar creates a healthier intrauterine environment and supports optimal brain development.
Dr Gupta advocated for early glucose testing, multidisciplinary care and even preconception counselling for women with known diabetes. “With strict glycaemic control, appropriate nutrition and regular antenatal monitoring, women can deliver healthy babies,” he said.
Postnatal care is equally important. Monitoring neonatal blood sugar levels and promptly addressing hypoglycaemia serves as a second line of defence, according to Dr Kekatpure.
“The key takeaway is perspective, not fear,” Dr Wadhawan said. “There is an association, but it is not a certainty. Proactive management makes a real difference.”
As research continues to clarify the link between maternal diabetes and epilepsy, doctors stress that vigilance, early diagnosis and evidence-based medical care remain the strongest safeguards for both mother and child.
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