Glucose, Insulin and Inner Ear Pathology

Abstract

One hundred consecutive patients with a clinical suspicion of metabolic inner ear disorder were submitted to a 5-hour glucose tolerance test with simultaneous titration of insulin. It was found that 82% of the patients presented abnormal glucose and/or insulin values. The analysis of the results revealed hypo- or hyperglycemia were present in only 41% of the cases, and that all patients had normal fast values for glucose. Hyperinsulinemia was the most frequent abnormality and was found to constitute the determining factor of the inner ear disorders. 26 of the patients presented Meniere's disease. The pathophysiological model for insulin-induced Meniere's disease is discussed. Follow-up data indicate that these patients respond well to a diet with reduced intake of small molecule carbohydrates.

Labirintopatia secundária aos distúrbios do metabolismo do açúcar: realidade ou fantasia?

“…It is a computed system that allows isolation and quantification of the participation of vestibular, visual and somatosensorial information, as well as sensorial integration, in maintaining body balance. The basic test run by CDP, Sensory Organization Test (SOT) provides information about organization and coordination of the motor response evoked by stimuli received in supine position 3 . The device has a reference surface in which the patient stands up.…”

“…One of the reasons for such disagreement lies in the impossibility of observing in vivo histopathological affections to the labyrinth, a situation that limits the investigation of the topic. The confirmation of higher prevalence of GMD in patients with cochlear-vestibular disorders when compared to the general population [1][2][3][4] is only indirect evidence of its importance in clinical manifestations presented by these patients.…”

Hearing in Children With Type I Diabetes Mellitus

“…This elevation in the audiometric thresholds may have occured due to periods of hypoglycemia and hypersinsulinism. Both reduce the function of sodium and potassium pumps in the inner ear, rise sodium concentration in the endolymph and alterate fluid dynamics of cochlear fluid with subsequent endolymphatic hydrops [16]. Therefore, this threshold increase may be transient.…”

“…Curiously, some authors [16,17] verified the occurrence of frequent alterations in the glycemic and insulinemic curves in patients with cochleovestibular symptoms and audiometric abnormalities. Carbohydrate metabolism disturbances, hyperglycemia as well as hypoglycemia and hyperinsulinism, defined as Kraft's criteria [18] may be associated to such symptoms even in young patients.…”

Hyperinsulinemia and Insulin Resistance: Scope of the Problem

“…1,2,3 Among these conditions are ailments as diverse as type 2 diabetes (T2D), CVD, 4 Alzheimer's disease (AD), 5,6,7 acne, 8,9 gout, 10,11,12 erectile dysfunction, 13 polycystic ovarian syndrome (PCOS) 14 and conditions that are typically deemed 'idiopathic', such as vertigo and tinnitus. 15,16,17 A growing body of evidence suggests that these wide-ranging and seemingly unconnected conditions can, in fact, be linked to a common underlying cause: metabolic derangement resulting primarily from chronic hyperinsulinemia, and its eventual end point, insulin resistance (IR).…”