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Balance disorders and diabetes mellitus – General considerations

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ABSTRACT
The objective of this review is to summarize specialty literature data regarding the relation between balance disorders and diabetes mellitus, because balance disorders and vestibular dysfunctions are common complaints in ENT practice in Romania and these complaints seem to be more frequent in diabetic patients. We accessed electronic databases like PubMed, Scopus (Elsevier), Web of Science for research on this theme; clinical trials, specialty books and meta-analysis reports, pointing out plausible explanations for the association between balance disorders and diabetes mellitus. Because of decreased proprioception and vision, diabetic patients suffer more often from balance disorders than the rest of population and are at higher risk of falling. That seems to be the consequence of a combination between impaired proprioception, vision, and possible damage produced by long term hyperglycemia in the vestibular system according to some studies.
Key words: vestibular dysfunctions, balance, diabetes mellitus.

INTRODUCTION
This paper is a brief review of specialty literature data regarding the relation between balance disorders and diabetes mellitus. Control systems (reactive, anticipatory, sensory, dynamic, and limits of stability) and physiological systems (vestibular, visual, proprioceptive, muscle strength, and reaction time) contribute to the maintenance of balance1. The somatosensory system provides information about the position and motion of body’s segments in relation to each other and the support surface by using proprioceptive and cutaneous inputs, the visual informs about the environment and body orientation, the vestibular system provides information about head position and spatial orientation2. Diabetic patients suffer more often from balance disorders than the rest of population and are at higher risk of falling. That seems to be the consequence of a combination between impaired proprioception, vision, and possible damage produced by long term hyperglycemia in the vestibular system according to some studies (a study on diabetic animals has shown that long-term hyperglycemia causes structural damage in the otolith organs of the vestibular system2).

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