Vestibular profile of type 1 versus type 2 chronic diabetes mellitus

Abstract

Objective: The present study aimed to describe and compare the vestibular profile of a random sample of patients with type 1 and type 2 diabetes mellitus (DM).Study design: Forty-five adult patients with DM were divided into three groups; group I: type 1 DM (n = 15), group II: type 2 DM treated with oral hypoglycaemic (n = 15), and group III: type 2 DM treated with insulin (n = 15). Diagnosis of vestibular disorders based on detailed history, Dizziness Handicap Inventory, clinical, and laboratory vestibular evaluation using videonystagmography test battery, electrocochleography, and cervical vestibular-evoked myogenic potential test. The study addressed the vestibular test results of the three diabetic groups and compared them. It also clarified the effect of different diabetic characteristics (clinical and laboratory) on the outcome of vestibular testing.Results: Vestibular disorders prevalence of 64.4% was estimated in diabetic patients with a higher prevalence was found in diabetic group III (86.7%) followed by group I (66.7%) then group II (40%). Vestibular function was significantly impaired in the insulin controlled DM compared to the orally controlled, and in the dizziness complainers compared to the non-complainers.Conclusions: A relatively high prevalence of vestibular dysfunctions were detected in DM. Diabetic patients treated with insulin, mainly those with type 2 DM, exhibited more involvement of the vestibular system owing to the long standing hyperglycemia with subsequent degenerative insults, microvascular lesions, and electrolyte imbalance. These changes could happen longtime prior to the onset of vestibular manifestations. Thus, early and routine vestibular assessment in diabetic patients is recommended even in absence of dizziness.