The role of diabetes mellitus in favoring peripheral vestibular system dysfunctions: Clinical and scientific evidence

Diabetes mellitus represents an important risk factor for accidental falls, particularly in the elderly. Due to chronic hyperglycemia and hyperinsulinemia patients with diabetes mellitus may have neurological deficits as peripheral neuropathy that is a debilitating microvascular complication affecting the proximal and distal peripheral sensory and motor nerves. This sensory neuropathy may contribute to cause postural instability in diabetic subjects. Moreover, diabetic retinopathy is another complication consequent to a breakdown of the inner blood-retinal barrier with accumulation of extracellular fluids in the macula and growth of new vessels causing retinal detachment. Together peripheral neuropathy and retinopathy favor the possibility of falls among diabetic subjects. Nevertheless, also a certain grade of vestibular end organs dysfunction should be supposed analyzing the balance capability of a diabetic person. Concerning the exact mechanism and localization of peripheral vestibular damage consequent to chronic hyperglycemia and hyperinsulinemia they are currently not still understood. The aim of our investigation was to analyze the studies focusing about the peripheral vestibular system alterations occurred in human beings or animals suffering of diabetes. On the basis of data reported in our review it appears plausible to hypothesize a direct connection among chronic hyperglycemic/hyperinsulinemic damage and peripheral vestibular organs dysfunction.