Vestibular dysfunction in people with diabetes is predicted by clinical measures of peripheral neuropathy and associated with imbalance and low physical activity.

Worse peripheral neuropathy predicted abnormal utricle and saccule vestibular function in people with diabetes.

• Logistic regression was used to predict VEMP responses from participant characteristics in all DM participants.
• Odds ratios for peripheral neuropathy measures predicting abnormal vestibular function ranged from 1.1 to 1.7.
• All predictive associations were statistically significant at p ≤ 0.05.
• Both the utricle pathway (ocular VEMP) and saccule pathway (cervical VEMP) were predicted by clinical PN measures.

Utricle function was most impaired in people with diabetes mellitus and peripheral neuropathy (DMPN), with the worst outcomes and more frequent absent responses compared to other groups.

• Utricle function was significantly worse in those with DMPN (p ≤ 0.04).
• Absent utricle (ocular VEMP) responses were more frequent in the DMPN group.
• The study compared VEMP outcomes between three groups: DM with peripheral neuropathy, DM without peripheral neuropathy, and controls (N = 68).
• VEMP outcomes included interamplitude and absent response counts.

Absent utricle responses, but not absent saccule responses, were associated with worse balance and lower physical activity in people with diabetes.

• Balance (measured by Functional Gait Assessment) and physical activity (measured by activity watch step counts) were significantly worse in those with absent utricle responses (p ≤ 0.03).
• No significant association was found between absent saccule responses and balance or physical activity outcomes.
• This differential finding suggests a pathway-specific impact of vestibular dysfunction on functional outcomes in DM.

The study used cervical and ocular vestibular evoked myogenic potential (VEMP) testing to characterize peripheral vestibular otolith dysfunction in people with diabetes.

• Cervical VEMP was used to assess saccule pathway function.
• Ocular VEMP was used to assess utricle pathway function.
• VEMP outcomes measured included interamplitude and absent response counts.
• The cross-sectional study included N = 68 participants across three groups: DM with PN, DM without PN, and controls.
• Participant characteristics collected included age and HbA1c, among others.

Clinical measures of peripheral neuropathy can provide rationale for vestibular testing in people with diabetes.

• The authors concluded that clinical PN measures can identify those who may benefit from vestibular testing.
• People with DM and abnormal utricle function demonstrated both imbalance and low physical activity.
• The Functional Gait Assessment and activity watch step counts were used to characterize participant function.