Abstract
Falls are among the most injurious, costly, and feared conditions affecting older
adults. Patients with diabetes have a significantly greater risk for falling due to
complications affecting the sensory systems required for balance: vision, proprioception,
and vestibular. The effects of diabetes mellitus on the vestibular system are perhaps
the least understood of these systems. The vestibular system is complex, includes
multiple structures, and is difficult and expensive to thoroughly assess. There is
pathophysiologic evidence suggesting a direct effect of diabetes mellitus complications
on the vestibular system, but there is limited clinical evidence regarding which specific
vestibular structures are most adversely affected. Nevertheless, large population-based
studies show that patients with diabetes are more likely to have vestibular loss,
have a high prevalence of a specific vestibular disorder called benign paroxysmal
positional vertigo, and are at a greater risk for falling. Based on the available
evidence, a balance screening and an evaluation of benign paroxysmal positional vertigo,
a common but easy to treat pathology, in patients with diabetes is recommended as
well as counseling on falls risk and home modifications.
Keywords
vestibular - risk of falls - diabetes mellitus - benign paroxysmal positional vertigo
