Diabetes and Auditory-Vestibular Pathology

Abstract

The relationship between diabetes mellitus (DM) and the auditory/vestibular system has been investigated for more than a century. Most population-based investigations of hearing loss in persons with diabetes (PWD) have revealed a slow progressive, bilateral, high-frequency sensorineural hearing loss. Despite the growing research literature on the pathophysiology of DM-related hearing loss using various animal models and other human studies, knowledge of specific mechanism of the degenerative changes of the inner ear and/or auditory nerve is far from full elucidation. Recent investigations of the mechanisms underlying the association between hearing loss and DM suggest complex combined contributions of hyperglycemia, oxidative stress resulting in cochlear microangiopathy, and auditory neuropathy. An even lesser understood complication of DM is the effect on the vestibular system. Here we provide an overview of animal and human evidence of pathophysiological changes created by DM and its effects on auditory-vestibular anatomy and function.

Hearing Loss and Cognitive Impairment: Epidemiology, Common Pathophysiological Findings, and Treatment Considerations

“…Neural presbycusis is referred traditionally to as the loss of spiral ganglia and to the damage of the cochlear nerve [27] with potential cochlear synaptopathy [28]. In this case, patients present a moderate downward slope in the pure tone threshold for high frequencies and a severe decrease in speech discrimination compared to the pure tone threshold [29].…”

Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz

“…toxic (Chapter 4.1.3.1, ▶ Fig. 2) aminoglycosides (especially gentamicin and tobramycin), cisplatin, loop diuretics, salicylate in high doses (5g/d) [396], penicillin + non-steroidal anti-inflammatory drugs [397], amiodarone [398], hydroxychloroquine [399], styrene poisoning [400], chronic exposure to jet fuel [401], cobalt toxicosis (e.g., hip replacement) [402] metabolic kidney failure, vitamin-B1, -B6, -B12 or folic acid deficiency [403], hypothyroidism, diabetes mellitus [404] neoplastic neurofibromatosis type II [413], skull base meningiomas, carcinomatous meningitis, metastases / lymphoma in the cerebellopontine angle [414] others aseptic meningitis [415], vestibular atelectasis (Chapter 3.2.8, ▶ Fig. 8), presbyvestibulopathy [416], auditory neuropathy spectrum disorders, otosclerosis [417] [298, 332] (▶ Fig.…”

Inner ear is a target for insulin signaling and insulin resistance: evidence from mice and auditory HEI-OC1 cells

“…Thus, defects in inner ear insulin action could contribute to the previously described association between diabetes and inner ear dysfunction. [1][2][3][4][5] It is possible that direct effects of insulin signaling on regulatory systems for fluid and ion homeostasis as well as energy metabolism act as a new regulatory mechanism for the organ of Corti in normal situations and in disease. Although in the present study mechanisms for the development of EH have not been addressed, it is possible that defects in insulin action in the organ of Corti contributes to the development of EH since the vasopressin/ aquaporin 2 system as well as key ion transporters, Na,K-ATPase and the sodium transporter Enac, are known to be expressed in the organ of Corti.…”

“…Ample evidence shows that type 1 and type 2 diabetes negatively impact on the function of the vestibular and auditory systems both in humans and in animal models. [1][2][3][4][5] Although several theories have been proposed (eg, microangiopathy, advanced glycation end products, reactive oxidative stress and mitochondrial dysfunction, demyelination of the auditory nerve, spiral ganglion loss and atrophic changes of organ of Corti cells [5][6][7][8][9] ), the exact underlying mechanisms responsible for diabetes-induced damage to the auditory system remain uncertain. The progression of hearing loss in mice with type 1 diabetes induced with streptozotocin or type 2 diabetes induced with high fat die (HFD), respectively, has been reported to have different characteristics as measured by auditory brain stem response and distortion products otoacustic emissions (DPOAE).…”