Diseases and symptoms associated with changes in postural balance in diabetics: an integrating literature review

Abstract

Purpose: to verify the diseases and symptoms associated with changes in postural balance in middle-aged and elderly individuals with type 2 diabetes mellitus. Methods: an integrative review was performed using the following descriptors: "Dizziness," "Vertigo," "Vestibular Diseases," "Labyrinth Diseases," and "Type 2, Diabetes Mellitus" in English and in Portuguese in databases such as PubMed, SciELO, LILACS, Web of Science, and Scopus. Observational articles involving individuals aged 40 years or more with type 2 diabetes mellitus and with alteration in postural balance having presented at least one disease or symptom associated with that alteration were selected. Results: the search yielded 1,209 articles, but only five met the eligibility criteria. Individuals in the selected studies had systemic arterial hypertension, high body mass index, peripheral neuropathy, and postural instability when walking on irregular surfaces and in the dark, when looking at moving objects, moving the head quickly and changing posture, resulting in stumbling when walking, and falls. The articles were classified as IIb and III, according to the levels of evidence of the American Speech-Language Hearing Association. Conclusion: the subjects in the studied articles presented cardiovascular alterations, peripheral neuropathy, vestibular symptoms, difficulties in tasks/movements in challenging contexts, and falls.

Perfil epidemiológico e avaliação do risco de queda em idosos usuários da Estratégia Saúde da Família

“…A tontura, um dos sintomas mais recorrentes nesses pacientes, tem sido apontada como uma nova complicação do DM e um potencial fator de risco para quedas. A insulina e os níveis séricos de glicose exercem grande influência sobre as alterações vestibulares periféricas, de tal modo que, esses níveis são diretamente proporcionais à predisposição do paciente em desenvolver disfunções vestibulares (Silva, et al, 2019;Gioacchini, et al, 2018).…”

“…Apesar do cenário de alta prevalência de DM e da relação com alterações no equilíbrio ser bem estabelecida, poucos são os estudos que trazem informações sobre a associação entre DM e vertigem no contexto da Saúde Pública. A presente pesquisa ao reconhecer as doenças associadas ao déficit de equilíbrio, como a DM, contribui para a elaboração de intervenções preventivas eficazes e oferecimento de um manejo adequado dos pacientes, já que tal comorbidade pode originar e / ou exacerbar as alterações do déficit de equilíbrio (Silva, et al, 2019).…”

Association between diabetes and vestibular dysfunction: an integrative review

“…Dizziness is characterized as the symptom of disturbed or impaired spatial orientation 6 . Middle-aged and older adults with DM2 who had dysfunctions in other organs and systems, as cardiovascular alterations, peripheral neuropathies, and vestibular symptoms, also present a greater risk of postural imbalance, making them more fragile and vulnerable to falls [7][8][9] .…”

“…Peripheral vestibular alterations are strongly influenced by insulin and glycemic levels circulating in the blood. The higher these levels, the greater is the patient's susceptibility in developing dysfunction of vestibular origin, as benign paroxysmal positional vertigo (BPPV), endolymphatic hydrops, and Ménière's disease 8,9 .…”