Asymptomatic Electronystagmographic Abnormalities in Patients with Type I Diabetes mellitus

Abstract

Only a few studies have investigated vestibular function in diabetes mellitus (DM), showing contradictory results. We have performed an electronystagmographic (ENG) evaluation of 46 individuals with type I DM and 37 healthy controls. No patient reported subjective vestibular symptoms. Duration of caloric-induced nystagmus (DN) was significantly lower (2.1 ± 0.7 vs. 2.6 ± 0.4 min, p < 0.01), and central nystagmus frequency of caloric response also nonsignificantly tended to be decreased (37.4 ± 16.5 vs. 41.7 ± 12.7 beats/30 s, p = 0.21) in DM patients, as compared to controls. The latter comparison achieved significance after exclusion of newly diagnosed diabetic patients (33.4 ± 16.1 vs. 41.6 ± 12.7 beats/s, p < 0.05). Depressed caloric reactions were seen in 21.8% of patients. DN was lower in patients with microalbuminuria and retinopathy, but this was not observed after exclusion of newly diagnosed diabetic patients, all of whom had normal ENG responses and no chronic diabetic complications. The existence of a lower DN and central nystagmus frequency should be borne in mind when interpreting ENG tracings in patients with long duration type I diabetes mellitus.

Are there any disturbances in vestibular organ of children and young adults with Type I diabetes?

“…Some reports show an improper electronystagmographic results in 50% of diabetic patients without any subjective symptoms [4]. Nevertheless the authors showed a correlation between electronystagmographic disturbances and duration of diabetes, positive correlation between electronystagmographic disturbances and diabetic complications and no correlation between electronystagmographic results and glycated haemoglobin concentration [4]. Similar to our results the disturbances were mostly of central type.…”

“…Some authors state that longer or shorter periods of hypoglycaemia have an important influence on diabetic encephalopathy occurrence [20]. Those results are inconsistent with data of other authors who did not show any correlation of electronystagmographic disturbances and hypoglycaemic incidents [4,18,19].…”

“…However, the influence of diabetes mellitus on vestibular organ as well as diagnostic and therapeutic implications arising from this fact seem to be still an open matter. Some reports show an improper electronystagmographic results in 50% of diabetic patients without any subjective symptoms [4]. Nevertheless the authors showed a correlation between electronystagmographic disturbances and duration of diabetes, positive correlation between electronystagmographic disturbances and diabetic complications and no correlation between electronystagmographic results and glycated haemoglobin concentration [4].…”

“…to [3]). Within the compass of years many authors proved different kinds of inner ear impairment, both in humans as well as in animals with diabetes induced experimentally [3,4,5,6,7]. There are sparse and often inconsistent data concerning the influence of different metabolic disturbances present in diabetes on vestibular organ.…”

Achados otoneurológicos em indivíduos portadores de Diabetes mellitus Tipo 1

“…In a sample of 46 Type I Diabetes mellitus patients, Biurrun 12 did not find any vestibular symptoms complaint, and 12 individuals showed vectoelectronystagmography alteration (2 individuals with labyrinthine predominance and 10 other individuals with directional preponderance). Rybak4 mentions a high rate of abnormalities seen at the vectoelectronystagmographic results in Diabetes mellitus patients who complained of dizziness.…”