Retrospective data suggests that the higher prevalence of benign paroxysmal positional vertigo in individuals with type 2 diabetes is mediated by hypertension

Abstract

Objective Benign Paroxysmal Positional Vertigo (BPPV) has been linked to comorbidities like diabetes and hypertension. However, the relationship between type 2 diabetes (DM) and BPPV is unclear. The purpose of this retrospective study was to examine the relationship between DM and BPPV in the presence of known contributors like age, gender and hypertension. Methods A retrospective review of the records of 3933 individuals was categorized by the specific vestibular diagnosis and for the presence of type 2 DM and hypertension. As the prevalence of BPPV was higher in people with type 2 DM compared to those without DM, multivariable logistic regressions were used to identify variables predictive of BPPV. The relationship between type 2 DM, hypertension and BPPV was analyzed using mediation analysis. Results BPPV was seen in 46% of individuals with type 2 DM, compared to 37% of individuals without DM (p<0.001). Forty two percent of the association between type 2 DM and BPPV was mediated by hypertension, and supported hypertension as a complete mediator in the relationship between type 2 DM and BPPV. Conclusions Hypertension may provide the mediating pathway by which diabetes affects the vestibular system. Individuals with complaints of dizziness, with comorbidities including hypertension and diabetes, may benefit from a screening for BPPV.

Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

“…One particular peripheral vestibular disorder, benign paroxysmal positional vertigo (BPPV), has been seen in higher frequency in people with diabetes [9, 10]. Cohen et al reported that 14% of their subjects with BPPV had a history of diabetes [9]; while D’Silva et al noted that BPPV was seen in 46% of individuals who had type 2 diabetes compared to 37% without diabetes [10].…”

“…Cohen et al reported that 14% of their subjects with BPPV had a history of diabetes [9]; while D’Silva et al noted that BPPV was seen in 46% of individuals who had type 2 diabetes compared to 37% without diabetes [10]. In addition, the presence of comorbidities like diabetes and hypertension are linked to the increased recurrence rate of BPPV [11].…”

The impact of diabetes on mobility, balance, and recovery after repositioning maneuvers in individuals with benign paroxysmal positional vertigo

“…Cohen et al reported 14% of the individuals in their sample with BPPV had a history of diabetes (Cohen, Kimball, & Stewart, 2004), while D’Silva et al noted that BPPV was seen in 46% of individuals with type 2 diabetes compared to 37% without diabetes (D’Silva et al, 2016). In a histopathology study examining human temporal bones, Yoda et al found a significantly higher prevalence of BPPV in people with type 1 diabetes compared to age matched controls (Yoda et al, 2011).…”

Otolith Dysfunction in Persons With Both Diabetes and Benign Paroxysmal Positional Vertigo

“…12, 13 Recent studies have shown that BPPV is present in higher frequency in people with both type 1 and type 2 diabetes compared to healthy controls. 14-16 …”