Does diabetes mellitus type 2 affect vestibular function? A systematic review and meta-analysis

Abstract

Aims: To explore the impact of diabetes mellitus type 2 (DMT2) on the vestibular system by differing in vestibular function (VF) results between people with and without DMT2. Methods: Relevant studies were identified through databases, including adults with DMT2 and controls. Only studies using objective VF tests were selected. For cervical vestibular evoked myogenic potential (cVEMP), ocular VEMP (oVEMP) and video Head Impulse Test (vHIT), results of both populations were compared using the random effects model. The prevalence of vestibular dysfunction (VD) was also considered. Results: 13 and 8 studies for qualitative and quantitative analysis were included. Prevalence of VD ranged from 7.7% to 84% in DMT2 individuals and 0%–15% in controls. VHIT and most VEMP-parameters yielded non-significant differences, except for n-amplitudes during oVEMP testing (-2.44 µV; 95%CI:-4.15 to -0.74; p = 0.005), interamplitude values in both cVEMP (-1.18; 95%CI:-2.28 to -0.09; p = 0.034) and oVEMP tests (-0.74; 95%CI:-1.24 to -0.23; p = 0.004; (subgroup-analysis)), although high heterogeneity was present (I² > 75%). Conclusion: There is evidence of higher VD prevalence in people with DMT2 compared to controls, independently of the presence of symptoms. More standardized measuring methods is needed to draw firmer conclusions regarding detection of subclinical VD.

Keywords

• Diabetes mellitus
• Vestibular function
• Vestibular evoked myogenic potentials
• Video head impulse test
• Meta-analysis