Hearing Loss, Dizziness, and Carbohydrate Metabolism
20 March 2015
06 May 2015
23 July 2015 (online)
Introduction Metabolic activity of the inner ear is very intense, and makes it sensitive to changes in the body homeostasis. This study involves a group of patients with inner ear disorders related to carbohydrate metabolism disturbances, including hearing loss, tinnitus, dizziness, and episodes of vertigo.
Objectives To describe the symptoms of metabolic inner ear disorders and the examinations required to establish diagnoses. These symptoms are often the first to allow for an early diagnosis of metabolic disorders and diabetes.
Methods Retrospective study of 376 patients with inner ear symptoms suggestive of disturbances of carbohydrate metabolism. The authors present patientś clinical symptoms and clinical evaluations, with emphasis on the glucose and insulin essays.
Results Authors based their conclusions on otolaryngological findings, diagnostic procedures and treatment principles. They found that auditory and vestibular symptoms usually occur prior to other manifestations of metabolic changes, leading to an early diagnosis of hyperinsulinemia, intestinal sugar malabsorption or diabetes. Previously undiagnosed diabetes mellitus type II was found in 39 patients.
Conclusions The identification of carbohydrate metabolism disturbances is important not only to minimize the patients' clinical symptoms, but also to help maintain their general health.
- 1 Jordão A. Estudos sobre a Diabete. Lisboa, Portugal: Typographia da Academia; 1864
- 2 Rust KR, Prazma J, Triana RJ, Michaelis IV OE, Pillsbury HC. Inner ear damage secondary to diabetes mellitus. II. Changes in aging SHR/N-cp rats. Arch Otolaryngol Head Neck Surg 1992; 118 (4) 397-400
- 3 Harrill JA. Headache and vertigo associated with hypoglycemic tendency. Laryngoscope 1951; 61 (2) 138-145
- 4 Tintera JW, Goldman HB. Hypoadrenocorticism in otolaryngologic surgical procedures. N Y State J Med 1956; 56 (6) 872-877
- 5 Goldman HB. Hypoadrenocorticism and endocrinologic treatment of Meniere's disease. N Y State J Med 1962; 62: 377-383
- 6 Powers WH. Metabolic aspects of Meniere's disease. Laryngoscope 1972; 82 (9) 1716-1725
- 7 Updegraff WR. Impaired carbohydrate metabolism and idiopathic Meniere's disease. Ear Nose Throat J 1977; 56 (4) 160-163
- 8 Kraft JR. Detection of diabetes mellitus in situ (occult diabetes). Lab Med 1975; 6 (2) 10-22
- 9 Kraft JR. Diabetes Epidemic and You. Trafford Publishing; 2008
- 10 Fukuda Y. Glicemia, Insulinemia e Patologia da Orelha Interna. [dissertation]. São Paulo: Escola Paulista de Medicina, 1982
- 11 Mangabeira Albernaz PL, Fukuda Y. Glucose, insulin and inner ear pathology. Acta Otolaryngol 1984; 97 (5–6) 496-501
- 12 Mangabeira-Albernaz PL, Fukuda Y, Vilela MP, Miszputen SJ. Vestibular disorders caused by defective enzyme mechanisms in the small intestine. Acta Otolaryngol 1985; 99 (3–4) 330-335
- 13 Mangabeira-Albernaz PL, Miszputen SJ. Vertigem e enzimas digestivas. In Zuma e MFC, Mangabeira APL, Carmona PL. Otoneurologia Atual. Rio de Janeiro: Revinter; 2014: 365-379
- 14 D'Avila C, Lavinsky L. Glucose and insulin profiles and their correlations in Ménière's disease. Int Tinnitus J 2005; 11 (2) 170-176
- 15 Zuma e Maia FC, Lavinsky L. Distortion product otoacoustic emissions in an animal model of induced hyperinsulinemia. Int Tinnitus J 2006; 12 (2) 133-139
- 16 Ramos S, Ramos RF , et al. Vertigem de Origem Metabólica. In Zuma and Maia FC, Mangabeira Albernaz PL, Carmona PL. Otoneurologia Atual, Rio de Janeiro, Brazil: Revinter; 2014: 349-364
- 17 Kuijpers W, Bonting SL. Studies on (Na+-K+)-activated ATPase. XXIV. Localization and properties of ATPase in the inner ear of the guinea pig. Biochim Biophys Acta 1969; 173 (3) 477-485
- 18 Koide Y, Tajima S, Yoshida M, Konno M. Biochemical changes in the inner ear induced by insulin, in relation to the cochlear microphonics. Ann Otol Rhinol Laryngol 1960; 69: 1083-1097
- 19 Mendelsohn M, Roderique J. Cationic changes in endolymph during hypoglycemia. Laryngoscope 1972; 82 (8) 1533-1540
- 20 Suzuki T, Matsunami T, Hisa Y, Takata K, Takamatsu T, Oyamada M. Roles of gap junctions in glucose transport from glucose transporter 1-positive to -negative cells in the lateral wall of the rat cochlea. Histochem Cell Biol 2009; 131 (1) 89-102
- 21 Nin F, Hibino H, Doi K, Suzuki T, Hisa Y, Kurachi Y. The endocochlear potential depends on two K+ diffusion potentials and an electrical barrier in the stria vascularis of the inner ear. Proc Natl Acad Sci U S A 2008; 105 (5) 1751-1756
- 22 Quraishi IH, Raphael RM. Generation of the endocochlear potential: a biophysical model. Biophys J 2008; 94 (8) L64-L66
- 23 Kakigi A, Okada T, Takeda T, Taguchi D, Nishioka R. Presence and regulation of epithelial sodium channels in the marginal cells of stria vascularis. Acta Otolaryngol 2008; 128 (3) 233-238
- 24 Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Järvelä I. Identification of a variant associated with adult-type hypolactasia. Nat Genet 2002; 30 (2) 233-237
- 25 Mattar R, Monteiro MdoS, Silva JMK, Carrilho FJ. LCT-22018G: A single nucleotide polymorphism is a better predictor of adult-type hypolactasia/lactase persistence in Japanese-Brazilians than LCT-13910C>T. Clinics (São Paulo) 2010; 65 (12) 1399-1400
- 26 Mangabeira-Albernaz PL. Inner Ear Disorders Induced by Impaired Carbohydrate Metabolism: a Long Term Follow Up. In Lim DJ, (eds.), Meniere's Disease and Inner Ear Homeostasis Disorders. Los Angeles, CA: House Ear Institute; 2005: 326-327