University of Kansas Medical Center, Department of Otolaryngology, 3901 Rainbow Boulevard Mailstop 3010, Kansas City, KS 66160, USA.
University of Kansas Medical Center, A.R. Dykes Library, 2100 W 39th Ave, Mailstop 1050, Kansas City KS 66103, USA.
Prim Care Diabetes. 2022 Aug;16(4):543-548. doi: 10.1016/j.pcd.2022.05.003. Epub 2022 May 31.
Olfactory dysfunction (OD) is highly prevalent amongst type 2 diabetes mellitus (DM2) patients and has many associated health risks. For example, OD can lead to poor nutrition, safety issues related to diminished hazard detection, and increased mortality rates. While limited research exists about therapeutics for DM2-associated OD, recovery of olfactory function is better studied in other pathologic states. The objectives of this scoping review are to synthesize the existing data on interventions for DM2-associated OD and present the evidence for therapies that have been utilized for non-DM2-associated causes of OD. Additionally, the potential therapeutic opportunities for patients with DM2 are explored.
A scoping review was conducted with a medical librarian to identify studies investigating treatments of DM2-related OD. 6 databases were searched (Embase, CINAHL, the Cochrane Library, Google Scholar, OVID Medline, and Web of Science). Studies were eligible if the primary discussion involved treatment of olfactory deficits in the context of DM2. All publication dates were included, and studies published in languages other than English were excluded.
3631 articles were identified; 3 articles met inclusion criteria and underwent full text review. Hyperbaric oxygen (HBO), the DPP-4 inhibitor Linagliptin and the GLP-1 agonists Exenatide and Liraglutide are the only therapeutics that have been used in the context of DM2. Only HBO and GLP-1 agonists produced statistically significant improvements in olfactory identification. The literature regarding non-DM2-associated OD supports interventions such as olfactory training, dietary supplements, and intranasal insulin. Specifically, olfactory training was very effective in many contexts such as post-viral and traumatic OD while being affordable and non-invasive.
This scoping review of olfactory rehabilitation options for DM2-induced OD demonstrates a paucity of prospective investigations of plausible therapeutics. Additionally, treatments for OD related to non-DM2-associated etiologies, such as olfactory training, are well-studied, efficacious, and should be investigated in the context of DM2. Future investigation has the potential to enhance the quality of clinical intervention for OD and improve short- and long-term outcomes for DM2 patients.
嗅觉功能障碍（OD）在 2 型糖尿病（DM2）患者中非常普遍，并且存在许多相关的健康风险。例如，OD 可能导致营养不良、危险察觉能力下降相关的安全问题，以及死亡率增加。虽然针对 DM2 相关 OD 的治疗方法的研究有限，但其他病理状态下的嗅觉功能恢复研究得更好。本综述的目的是综合现有的关于 DM2 相关 OD 干预措施的数据，并介绍已用于非 DM2 相关 OD 病因的治疗方法的证据。此外，还探讨了 DM2 患者的潜在治疗机会。
与医学图书馆员合作进行了范围综述，以确定研究 DM2 相关 OD 治疗方法的研究。共检索了 6 个数据库（Embase、CINAHL、Cochrane 图书馆、Google Scholar、OVID Medline 和 Web of Science）。如果主要讨论涉及 DM2 背景下嗅觉缺陷的治疗，则符合纳入标准。包括所有出版日期，排除非英语发表的研究。
共确定了 3631 篇文章；3 篇文章符合纳入标准并进行了全文审查。高压氧（HBO）、DPP-4 抑制剂利拉鲁肽和 GLP-1 激动剂艾塞那肽和利拉鲁肽是唯一在 DM2 背景下使用的治疗方法。只有 HBO 和 GLP-1 激动剂在嗅觉识别方面产生了统计学上的显著改善。非 DM2 相关 OD 的文献支持干预措施，如嗅觉训练、膳食补充剂和鼻内胰岛素。具体而言，嗅觉训练在许多情况下非常有效，例如病毒后和创伤后 OD，同时具有可负担性和非侵入性。
本综述对 DM2 引起的 OD 的嗅觉康复选择进行了研究，表明针对 DM2 诱导的 OD 的合理治疗方法的前瞻性研究很少。此外，针对非 DM2 相关病因引起的 OD 的治疗方法，如嗅觉训练，已有充分的研究、有效，并且应该在 DM2 背景下进行研究。未来的研究有可能提高 OD 临床干预的质量，并改善 DM2 患者的短期和长期预后。
