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World J Clin Pediatr. Jan 9, 2022; 11(1): 61-70
Published online Jan 9, 2022. doi: 10.5409/wjcp.v11.i1.61
Vestibular function for children with insulin dependent diabetes using cervical vestibular evoked myogenic potentials testing
Sherifa Ahmed Hamed, Kotb Abbas Metwalley, Hekma Saad Farghaly, Amira Mohamed Oseily
Sherifa Ahmed Hamed, Department of Neurology and Psychiatry, Assiut University Hospitals, Assiut 71516, Egypt
Kotb Abbas Metwalley, Hekma Saad Farghaly, Department of Pediatrics, Assiut University Hospitals, Assiut 71516, Egypt
Amira Mohamed Oseily, Department of ENT (Auditory Unit), Assiut University Hospitals, Assiut 71516, Egypt
Author contributions: Hamed SA, Metwalley KA and Farghaly HS carried out the clinical evaluation of participants, design of the study, statistical analyses and manuscript drafting; Oseily AM carried out the audiology and vestibular evaluations and participated in study design, statistical analyses and drafting the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the local research ethics committee of Faculty of medicine, Assiut University, Assiut, Egypt, No. AUFM_PED_232/2019.
Informed consent statement: Parents/guardians provided their written informed consent for participation of their children in the study.
Conflict-of-interest statement: The authors declared no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sherifa Ahmed Hamed, MD, Professor, Department of Neurology and Psychiatry, Assiut University Hospital, Floor # 7, Room # 4, P.O.Box, Assiut 71516, Egypt. hamedsherifa@aun.edu.eg
Received: January 6, 2021
Peer-review started: January 6, 2021
First decision: June 5, 2021
Revised: July 17, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: January 9, 2022
Processing time: 365 Days and 8.6 Hours
ARTICLE HIGHLIGHTS
Research background

Integrity of vestibular organs and their reflexes is critical for maintaining balance in static condition and during motion and gaze stabilization. In healthy individuals, the brain organizes and integrates information from vision, proprioception and vestibular system. Diabetes is a common chronic metabolic/systemic disease. It causes complications in every organ of the body, especially the eyes, kidney, nerves, heart and blood vessels. Experimental and clinical studies provide evidence that peripheral and/or central auditory and/or vestibular systems' dysfunctions are common complications of diabetes. The mechanism of diabetic vestipulopathy is complex and still has to be explored. It may be related to diabetic complications or its comorbid conditions. It may also be due to alteration of inner ears homeostasis due to diabetic metabolic alterations associated with poor glycemic control.

Research motivation

Vestibulopathy is a known complication in adults with diabetes. The research hotspots include (1) Identification of the spectrum of vestibular and auditory manifestations due to diabetes mellitus and their predictors; (2) Understanding the temporal relation between the onset of diabetes and the development of auditory or vestibular manifestations; and (3) Determining whether diabetes itself and/or its comorbid medical conditions are causes of auditory and vestibular complications.

Research objectives

In children, this is the first study that systematically estimated the prevalence and predictors of vestibular injury or dysfunction with type 1 diabetes.

Research methods

Cervical vestibular evoked myogenic potential (cVEMP) type of VEMP testing was used for assessment of the saccular function of the otolith organ and its pathways.

Research results

Bilateral changes in cVEMP abnormalities are more frequent than unilateral. They are associated with chronic and severe diabetes.

Research conclusions

Injury of the saccule of the inner ear and its central connection occurs with type 1 diabetes.

Research perspectives

Multidisciplinary team is required to follow up regularly children with diabetes for prevention and early identification and treatment of associated complications. The treating endocrinologists have to optimize management of diabetes and its associated comorbidities and complications.