When, where, and why should we look for vestibular dysfunction in people with diabetes mellitus?

This is a narrative review without a systematic search strategy or formal quality appraisal of the included studies. The included human studies had highly heterogeneous designs, sample sizes, and diagnostic criteria, making direct comparisons difficult. Most studies were cross-sectional, so it is unclear if vestibular dysfunction progresses with disease duration or glycemic control. Few studies directly correlated vestibular test results with functional balance outcomes, leaving the clinical impact of the found abnormalities unknown. The review excluded studies involving patients with dizziness or vertigo, so findings do not apply to symptomatic individuals.

The authors declared no financial support was received for the research, authorship, or publication of this article.

Do not assume that finding vestibular abnormalities on testing explains a patient's balance issues. The review states that evidence linking vestibular dysfunction to imbalance in this population is limited and circumstantial, and that peripheral neuropathy and retinopathy are more established drivers of falls in people with diabetes.