Li Jin, Jiang Jana, Zhang Yi, Liu Bo, Zhang Luo
Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.
Audiol Neurootol. 2019;24(3):154-160. doi: 10.1159/000501291. Epub 2019 Jul 19.
Recent evidence suggests that falls are a major complication of diabetes in elderly patients, leading to disability and preventable death. However, the potential risk factors leading to falls in patients with type 2 diabetes are not fully understood. This study was designed to explore the characteristics of vestibular dysfunction and balance control in patients with type 2 diabetes and to analyse the risk factors associated with falls.
The study recruited 51 patients with type 2 diabetes and 43 controls who underwent vestibular function tests and balance control capability tests between January 2013 and December 2015. Vestibular function and balance control capability assessment was based on slow-phase velocity, canal paresis, Sensory Organisation Test (SOT) score, Limits of Stability Test (LOS) score, and Motor Control Test (MCT) score.
In all, 56.7% of the diabetic patients had vestibular dysfunction, compared with 27.9% of the controls (p = 0.005). Vestibular dysfunction was dependent on the duration of the disease and serum HbA1c levels. There were no significant differences between the two groups with respect to the balance test results for SOT score, somatosensory subtest score, vestibular subtest score, or LOS score. However, the visual system and MCT scores were significantly lower in the diabetic patients than in the controls (p = 0.032 and p = 0.018, respectively).
Patients with type 2 diabetes have a higher incidence of vestibular dysfunction. Vestibular dysfunction, visual system impairment, and a decline in motion control may be the risk factors that can lead to falls, and thus need to be managed accordingly in diabetic patients.
最近的证据表明，跌倒在老年糖尿病患者中是一种主要并发症，会导致残疾和可预防的死亡。然而，导致2型糖尿病患者跌倒的潜在风险因素尚未完全明确。本研究旨在探讨2型糖尿病患者的前庭功能障碍和平衡控制特点，并分析与跌倒相关的风险因素。
本研究招募了51例2型糖尿病患者和43名对照者，他们在2013年1月至2015年12月期间接受了前庭功能测试和平衡控制能力测试。前庭功能和平衡控制能力评估基于慢相速度、半规管轻瘫、感觉组织测试（SOT）得分、稳定极限测试（LOS）得分和运动控制测试（MCT）得分。
总体而言，56.7%的糖尿病患者存在前庭功能障碍，而对照组为27.9%（p = 0.005）。前庭功能障碍取决于疾病持续时间和血清糖化血红蛋白水平。两组在SOT得分、躯体感觉子测试得分、前庭子测试得分或LOS得分的平衡测试结果方面无显著差异。然而，糖尿病患者的视觉系统和MCT得分显著低于对照组（分别为p = 0.032和p = 0.018）。
2型糖尿病患者前庭功能障碍的发生率较高。前庭功能障碍、视觉系统损害和运动控制下降可能是导致跌倒的风险因素，因此在糖尿病患者中需要相应地进行管理。
