Semin Hear 2019; 40(04): 300-307
DOI: 10.1055/s-0039-1697032
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diabetes and the Vestibular System

Erin G. Piker
1  Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia.
,
Daniel J. Romero
1  Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia.
› Author Affiliations
Further Information

Publication History

Publication Date:
09 October 2019 (online)

Abstract

Falls are among the most injurious, costly, and feared conditions affecting older adults. Patients with diabetes have a significantly greater risk for falling due to complications affecting the sensory systems required for balance: vision, proprioception, and vestibular. The effects of diabetes mellitus on the vestibular system are perhaps the least understood of these systems. The vestibular system is complex, includes multiple structures, and is difficult and expensive to thoroughly assess. There is pathophysiologic evidence suggesting a direct effect of diabetes mellitus complications on the vestibular system, but there is limited clinical evidence regarding which specific vestibular structures are most adversely affected. Nevertheless, large population-based studies show that patients with diabetes are more likely to have vestibular loss, have a high prevalence of a specific vestibular disorder called benign paroxysmal positional vertigo, and are at a greater risk for falling. Based on the available evidence, a balance screening and an evaluation of benign paroxysmal positional vertigo, a common but easy to treat pathology, in patients with diabetes is recommended as well as counseling on falls risk and home modifications.