Blood glucose and insulin levels in patients with peripheral vestibular disease

Abstract

Met abolic disorders can cause dizziness. Aim: to study the prevalence of glucose and glucose-insulin alterations in patients with peripheral vestibular disorders by studying the four-hour glucose-insulin curve; to check at what time there was the highest prevalence of altered cases and whether the glucose and insulin curves together are better than the isolate glucose curve and fasting glucose curve. Materials and Methods: retrospective study, analyzing 81 four-hour glucose-insulin curves in patients with peripheral vestibular dizziness. Results: Four-hour glucose-insulin curve alterations happened in 87.7% of the patients. Hypoglycemia was seen in 61.7% of the cases, hyperinsulinemia in 55.5%, hyperglycemia in 27.2%, glucose intolerance in 12.3% and hypoinsulinemia in 1.2%. Normal tests were seen in 12.3 % of the cases and altered fasting glucose in 23.5%. Conclusions: The fourhour glucose-insulin curve analysis showed that 87.7% of the patients with dizziness and suspicion of peripheral vestibular disorder had glucose or insulin metabolism disorders. The highest number of alterations was seen up to the third and fourth hour of the glucose-insulin curve. The glucose and insulin curves together overcame the glucose curve alone and fasting glucose curve in regards of the prevalence of altered cases.

Hyperinsulinemia and hyperglycemia: risk factors for recurrence of benign paroxysmal positional vertigo

“…These metabolic disorders can act as a principal etiological factor in vestibular dysfunction, as well as an aggravating factor of a pre-existing vestibular disorder. 9 We did not find statistical significance for patients with glucose intolerance in relation to the number of recurrences, compared to normal subjects. This finding may suggest that this degree of change in carbohydrate metabolism is not significant to the point of an association with the evolution of BPPV.…”

“…8,9 Furthermore, the labyrinth is very sensitive to small changes in plasma insulin levels, due to the large number of insulin receptors present in the endolymphatic sac. 11 Based on these suggestive signs (i.e., that glucose metabolism may be associated to clinical pictures of benign paroxysmal positional vertigo), this study found some relations, such as: the hyperinsulinemic patient has a RR 4.6 times higher for BPPV recurrence, compared with the general population ---a statistically significant finding.…”

Há Relação Entre Distúrbios Metabólicos E Alterações Vestibulococleares? / Is There a Relationship Between Metabolic Disorders and Vestibulocochlear Dysfunctions?

“…A intensa atividade metabólica da estria vascular é dependente de oferta otimizada de ATP para garantir o funcionamento da bomba de sódio e potássio e, assegurar concentrações iônicas adequadas na endolinfa da orelha interna. (SERRA et. al, 2009) GANANÇA et.…”

“…al (2003, acrescenta que a resistência periférica à insulina e a hiperinsulinemia podem gerar alteração do metabolismo lipídico como hipertrigliceridemia.SAITO T et al (1986) igualmente citado no estudo, esclarece que os efeitos supostos do distúrbio metabólico lipídico são lesões das células ciliadas cocleares, experimentalmente verificado na monitorização da orelha interna sob ação de dietas hiperlipídicas. Sob o mesmo prisma, o hipotireoidismo deve também, ao lado das alterações do metabolismo de carboidratos, ser aventado frente uma dislipidemia SERRA et al (2009). define que além de causadores de distúrbios vestibulares, as disfunções metabólicas podem funcionar como agentes de piora de vestibulopatias pré-existentes.…”

Isolated versus Drug Combined Vestibular Rehabilitation for the Treatment of Metabolic Dizziness

“…Metabolic dysfunctions are considered responsible for labyrinthine changes [1]. Metabolic disorders may act as the main etiological factor in vestibular dysfunction or as an aggravating factor in preexisting vestibular disease [2].…”