Utricular hypofunction in patients with type 2 diabetes mellitus

The aim of this study was to assess the function of the utricle and horizontal semicircular canals in patients with type 2 diabetes mellitus receiving primary health care, with/without a history of falls. 101 patients with type 2 diabetes mellitus, 34 to 84 years old (26 with and 75 without a history of falls) and 51 healthy volunteers (40-83 years old) accepted to participate. They denied having a history of dizziness, vertigo, unsteadiness, hearing loss, or neurological disorders. None of them were seeking care due to sensory or balance decline. After a clinical evaluation and report of symptoms related to balance using a standardised questionnaire, lateral canal function was assessed by sinusoidal rotation at 0.16 Hz and 1.28 Hz (60°/sec peak velocity), otolith function was assessed by static visual vertical (average of 10 trials) and dynamic visual vertical during unilateral centrifugation (300°/sec at 3.5 cm) and static posturography was performed on hard/ soft surface with eyes open/closed. Compared to healthy volunteers, patients showed decreased responses to unilateral centrifugation, but similar responses to horizontal canal stimuli (independently of age, peripheral neuropathy or a history of falls) (ANCoVA p < 0.05) and a larger sway area with a lengthier sway path. Compared to patients with no falls, patients with falls had a higher female/male ratio and a higher frequency of score ≥ 4 on the questionnaire of symptoms related to balance, but similar age, body mass index and frequency of peripheral neuropathy. In patients with type 2 diabetes mellitus, receiving primary healthcare who are not seeking care due to sensory or balance decline, utricular function may be impaired even in the absence of horizontal canal dysfunction or a history of falls.