Effect of HbA1c level on vestibular system among patients with Diabetes Mellitus

Abstract

Background & Aim: Sensorineural Hearing Loss (SNHL) resulting from microangiopathy is one of the recognised consequences of Diabetes Mellitus (DM), a multisystem illness. Although there is enough evidence linking diabetes to hearing difficulties, less is known about how the disease affects the vestibular system, particularly in the Indian population. The purpose of this research is to look at the relationship between vestibular function and HbA1c levels, a crucial indicator of glycaemic management, in individuals with Type-II Diabetes Mellitus (T2DM). Method: A cross-sectional research including 167 T2DM patients between the ages of 31 and 60 was carried out. Cervical and Ocular Vestibular Evoked Myogenic Potentials (cVEMP & oVEMP) along with subjective test (Head Impulse Test & Timed Up and Go) were used to assess vestibular function, and patients were classified into two groups according to their HbA1c levels. T2DM controlled DM (HbA1c < 7%) and uncontrolled DM (HbA1c > 7.1%). Results & Conclusion: As shown by the fact that 100% of patients with uncontrolled diabetes had positive Head Impulse Test (HIT) & Timed Up and Go (TUG) test, the data demonstrated a substantial link between vestibular dysfunction and diabetes. Comparing the uncontrolled DM group to the controlled diabetes group, significant VEMP latency delays were seen, especially for the cVEMP and oVEMP among uncontrolled T2DM than controlled T2DM. These results imply that chronic hyperglycemia may affect vestibular function, raising the possibility of falls and balance issues in diabetics. Remarkably, there were no significant variations in vestibular responses between subjects who were male and female. This research emphasises the need of glycaemic management in maintaining vestibular function in individuals with uncontrolled T2DM than controlled T2DM. It also emphasises the necessity of early detection and vestibular deficit rehabilitation in order to avoid related consequences like falls. It is necessary to conduct more research to investigate the underlying processes and develop standardised techniques for the evaluation of vestibular function in individuals with DM.