The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy
Aim This study aimed to determine the association between vestibular dysfunction, falls, and postural instability in individuals with type 2 diabetes (T2D) compared to healthy control individuals and to examine the impact of diabetic polyneuropathy (DPN). Methods This cross-sectional study included...
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PeerJ Inc.
2023-11-01
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| Online Access: | https://peerj.com/articles/16382.pdf |
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| author | Ina Ejsing Hunnerup Jørgensen Louise Devantier Hatice Tankisi Henning Andersen Karolina Snopek Khan |
| author_facet | Ina Ejsing Hunnerup Jørgensen Louise Devantier Hatice Tankisi Henning Andersen Karolina Snopek Khan |
| author_sort | Ina Ejsing Hunnerup Jørgensen |
| collection | DOAJ |
| description | Aim This study aimed to determine the association between vestibular dysfunction, falls, and postural instability in individuals with type 2 diabetes (T2D) compared to healthy control individuals and to examine the impact of diabetic polyneuropathy (DPN). Methods This cross-sectional study included individuals with T2D with DPN (n = 43), without DPN (n = 32), and healthy controls (n = 32). Cervical and ocular vestibular evoked myogenic potentials (VEMP) were recorded, and latencies and amplitudes were determined. DPN was diagnosed based on nerve conduction studies and clinical scores. Postural instability was examined using a static posturographic balance system and calculated as an instability index (ST). Falls were recorded retrospectively during the past year. Group comparisons were conducted by using univariate and bivariate statistics. Results Individuals with T2D experienced more falls than healthy controls (T2D with DPN n = 12[38%], T2D without DPN n = 15[35%], controls n = 5[16%], p = 0.04). Individuals with T2D had decreased postural stability, T2D with DPN, ST (median of 52[iqi = 33; 77]), T2D without DPN, ST (median of 31[iqi = 24; 39]), controls ST (median of 26[iqi = 19; 33], p = 0.01), when comparing all three groups. Individuals with T2D had a greater number of no-responses in oVEMP compared to controls (T2D with DPN, n = 15[46.9%] T2D without DPN n = 25[58.1%], controls n = 9[28.1%], p = 0.04). No difference was found in cVEMP and oVEMP amplitudes in any of the groups. Irrespectively of DPN, fallers with T2D had decreased oVEMP and cVEMP latencies on the right ears, when comparing to non-fallers, respectively, n10 (fallers [median of 16, iqi=15;19 ms.] vs. non-fallers [median of 25 iqi=16;35 ms]); p13 (fallers [median of 16, iqi=15;17 ms.] vs. non-fallers [median of 15, iqi=8;16 ms.], p < 0.05). Conclusion Falls and postural instability were more frequent in individuals with T2D compared to healthy controls. Fallers with T2D had vestibular end-organ impairments based on the oVEMP and cVEMP latencies on the right but not the left ears, irrespective of DPN. Individuals with T2D had more frequent no-response of the oVEMP, indicating impaired vestibular nerve function. |
| first_indexed | 2024-03-11T10:25:22Z |
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| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-11T10:25:22Z |
| publishDate | 2023-11-01 |
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| spelling | doaj.art-15ecbcbbd476435d8c07ab1f488fd1bd2023-11-15T15:05:11ZengPeerJ Inc.PeerJ2167-83592023-11-0111e1638210.7717/peerj.16382The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathyIna Ejsing Hunnerup Jørgensen0Louise Devantier1Hatice Tankisi2Henning Andersen3Karolina Snopek Khan4Department of Neurology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Otorhinolaryngology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Neurophysiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Neurology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Neurology, Aarhus University Hospital, Aarhus, DenmarkAim This study aimed to determine the association between vestibular dysfunction, falls, and postural instability in individuals with type 2 diabetes (T2D) compared to healthy control individuals and to examine the impact of diabetic polyneuropathy (DPN). Methods This cross-sectional study included individuals with T2D with DPN (n = 43), without DPN (n = 32), and healthy controls (n = 32). Cervical and ocular vestibular evoked myogenic potentials (VEMP) were recorded, and latencies and amplitudes were determined. DPN was diagnosed based on nerve conduction studies and clinical scores. Postural instability was examined using a static posturographic balance system and calculated as an instability index (ST). Falls were recorded retrospectively during the past year. Group comparisons were conducted by using univariate and bivariate statistics. Results Individuals with T2D experienced more falls than healthy controls (T2D with DPN n = 12[38%], T2D without DPN n = 15[35%], controls n = 5[16%], p = 0.04). Individuals with T2D had decreased postural stability, T2D with DPN, ST (median of 52[iqi = 33; 77]), T2D without DPN, ST (median of 31[iqi = 24; 39]), controls ST (median of 26[iqi = 19; 33], p = 0.01), when comparing all three groups. Individuals with T2D had a greater number of no-responses in oVEMP compared to controls (T2D with DPN, n = 15[46.9%] T2D without DPN n = 25[58.1%], controls n = 9[28.1%], p = 0.04). No difference was found in cVEMP and oVEMP amplitudes in any of the groups. Irrespectively of DPN, fallers with T2D had decreased oVEMP and cVEMP latencies on the right ears, when comparing to non-fallers, respectively, n10 (fallers [median of 16, iqi=15;19 ms.] vs. non-fallers [median of 25 iqi=16;35 ms]); p13 (fallers [median of 16, iqi=15;17 ms.] vs. non-fallers [median of 15, iqi=8;16 ms.], p < 0.05). Conclusion Falls and postural instability were more frequent in individuals with T2D compared to healthy controls. Fallers with T2D had vestibular end-organ impairments based on the oVEMP and cVEMP latencies on the right but not the left ears, irrespective of DPN. Individuals with T2D had more frequent no-response of the oVEMP, indicating impaired vestibular nerve function.https://peerj.com/articles/16382.pdfType 2 diabetesDiabetic polyneuropathyPostural instabilityVestibular Evoked Myogenic PotentialFalls |
| spellingShingle | Ina Ejsing Hunnerup Jørgensen Louise Devantier Hatice Tankisi Henning Andersen Karolina Snopek Khan The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy PeerJ Type 2 diabetes Diabetic polyneuropathy Postural instability Vestibular Evoked Myogenic Potential Falls |
| title | The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| title_full | The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| title_fullStr | The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| title_full_unstemmed | The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| title_short | The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| title_sort | impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy |
| topic | Type 2 diabetes Diabetic polyneuropathy Postural instability Vestibular Evoked Myogenic Potential Falls |
| url | https://peerj.com/articles/16382.pdf |
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