Vestibular function for children with insulin dependent diabetes using cervical vestibular evoked myogenic potentials testing

Table 1 The demographic, clinical and laboratory characteristics of the studied children

Demographic, clinical and laboratory characteristics	Patients (n = 40)	Controls (n = 25)	P value
Age, yr	10-18 (13.63 ± 1.50)	9-18 (15.44 ± 1.22)	0.438
Sex, n (%)
Male	10 (25)	9 (36)	0.185
Female	30 (75)	16 (64)	0.223
BMI	15.70-25.30 (20.53 ± 2.52)	15.20-27.50 (18.86 ± 2.63)	0.278
Systolic blood pressure, mmHg	100-130 (110.80 ± 10.50)	100-120 (105.00 ± 8.50)	0.365
Diastolic blood pressure, mmHg	60-80 (70.55 ± 2.34)	60-70 (68.33 ± 5.20)	0.544
Age at onset of diabetes, yr	4–15 (8.54 ± 2.33)	-	-
Duration of diabetes, yr	3–10 (5.62 ± 2.80)	-	-
≤ 5	9 (22.5)
> 5	31 (77.5)
DKA, n (%)	22 (55)	-	-
Number of attacks	0–6 (3.44 ± 0.43)
Hypoglycemia, n (%)	12 (30)	-	-
Number of attacks	0–6 (2.50 ± 0.32)
Family history of diabetes, n (%)	18 (45)	3 (12)	0.01
Hb1Ac, n (%)	5.00–15.65 (8.68 ± 1.50)	3.00–6.00 (3.90 ± 0.25)	0.001
≤ 7%	4 (10)
> 7%	36 (90)
Insulin dose, IU/kg/d	0.80–2.10 (1.70 ± 0.32)	-	-
Lipid profile, mg/dL
Total cholesterol	100-250 (180.20 ± 20.50)	90–200 (140.21 ± 15.65)	0.06
Triglycerides	60-280 (168.52 ± 22.50)	50–120 (80.50 ± 20.58)	0.001
LDL	50-160 (100.65 ± 10.62)	65–110 (85.43 ± 6.46)	0.08
HDL	45-65 (55.52 ± 5.33)	35–70 (48.33± 5.62)	0.364
Comorbid medical conditions, n (%)
Hypertension	5 (12.5)	-	-
Hypercholesterolemia/dyslipidemia	8 (20)	-	-
Serum creatinine, mg/dL	0.54–1.20 (0.80 ± 0.15)	0.40–0.90 (0.62 ± 0.05)	0.450
Diabetic complications, n (%)
Nephropathy	6 (15)	-	-
Peripheral neuropathy	16 (40)	-	-
Dizziness, n (%)	6 (10)	-	-

BMI: Body mass index; LDL: Low density lipoprotein; HDL: High density lipoprotein; Hb1Ac: Hemoglobin A1c; DKA: Diabetic ketoacidosis.

Table 2 Cervical vestibular evoked myogenic potential results of the studied groups (mean ± SD)

Variables	Children with T1D (n = 40)	Controls (n = 25)	P value (P1)	P value (P2)
P1 latency, n1 (%)
Unilateral	6 (15)	-	-	-
Bilateral	10 (25)	-	-	-
Range, ms
Right ear	18.00–22.00 (20.16 ± 1.34)	10.40–16.40 (12.03 ± 1.01)	0.03	0.542
Left ear	13.00–29.00 (20.40 ± 1.10)	10.40–17.60 (14.25 ± 1.68)	0.02
N1 latency, n1 (%)
Unilateral	6 (15)	-	-	-
Bilateral	10 (25)	-	-	-
Range, ms
Right ear	22.00–33.00 (28.30 ± 2.66)	18.65–26.70 (22.43 ± 1.82)	0.04	0.364
Left ear	24.00–36.80 (32.35 ± 2.84)	16.82–30.82 (26.45 ± 1.02)	0.03
P1-N1 amplitude, n1 (%)
Unilateral	10 (25)	-	-	-
Bilateral	24 (60)	-	-	-
Range, μV
Right ear
Range	20.00–90.00	48.60–92.80	0.001	0.458
Median	44.20	72.43
25th	36.00	60.35
50th	40.45	76.44
75th	48.55	86.62
Left ear
Range	26.68–86.00	46.03–98.00	0.001
Median	46.20	74.68
25th	33.25	54.36
50th	45.00	80.00
75th	56.25	88.56
AR
Range	1.12–66.20	0.0-15.8	0.001
Median	18.30	4.88
25th	6.58	1.88
50th	13.36	2.90
75th	32.44	6.30
n1 (%)	10 (25)	0

¹Number of subjects with vestibular evoked myogenic potential abnormalities results.

P1: Significance for patients vs controls; P2: Significance for patients' right vs left ear; AR: Asymmetry ratio; T1D: Type 1 diabetes.

Table 3 Cervical vestibular evoked myogenic potential's results for children with type 1 diabetes in relation to their demographic, clinical and laboratory variables

Variables	P1	N1	P1-N1 amplitude	AR
Sex
Male (n = 10)	22.35 ± 1.12	26.32 ± 2.30	44.82	10.33
P1	0.02	0.320	0.01	0.01
Female (n = 30)	18.22 ± 1.63	32.55 ± 1.22	38.36	16.85
P1	0.04	0.01	0.001	0.001
P2	0.125	0.01	0.06	0.126
Duration of diabetes, yr
≤ 5 yr (n = 9)	16.68 ± 1.23	22.65 ± 2.22	38.30	6.50
P1	0.02	0.244	0.03	0.05
> 5 yr (n = 31)	28.33 ± 1.11	35.07 ± 2.31	56.26	18.68
P1	0.01	0.01	0.001	0.0001
P2	0.006	0.01	0.001	0.452
Dizziness
Yes (n = 6)	26.03 ± 1.33	34.68 ± 2.57	38.64	10.64
P1	0.002	0.01	0.001	0.01
No (n = 32)	16.23 ± 1.28	28.05 ± 2.28	56.00	16.28
P1	0.138	0.302	0.001	0.001
P2	0.02	0.03	0.01	0.06
Hb1Ac, %
≤ 7 (n = 4)	16.83 ± 1.30	22.01 ± 1.20	60.00	8.64
P1	0.306	0.358	0.08	0.023
> 7 (n = 36)	25.633 ± 1.28	34.55 ± 1.33	32.50	18.28
P1	0.04	0.01	0.001	0.804
P2	0.01	0.01	0.001	0.246
DKA
Yes (n = 22)	27.23 ± 1.20	34.25 ± 1.88	38.50	16.35
P1	0.01	0.01	0.001	0.001
No (n = 18)	14.84 ± 1.11	21.15 ± 1.23	55.84	8.00
P1	0.358	0.682	0.01	0.04
P2	0.003	0.001	0.01	0.323
Hypoglycemia	26.86 ± 1.80	34.22 ± 2.02	30.40	12.86
Yes (n = 12)
P1	0.01	0.01	0.001	0.01
No (n = 28)	16.50 ± 1.44	25.24 ± 2.562	54.68	10.35
P1	0.05	0.05	0.01	0.01
P2	0.02	0.03	0.03	0.286
Peripheral neuropathy
Yes (n = 16)	23.28 ± 1.30	32.26 ± 1.45	35.06	16.60
P1	0.001	0.01	0.001	0.01
No (n = 24)	16.44 ± 1.03	24.24 ± 1.40	52.66	13.44
P1	0.458	0.542	0.01	0.01
P2	0.02	0.03	0.02	0.322
Control subjects	13.22 ± 1.30	23.82 ± 1.37	74.68	4.88

DKA: Diabetic ketoacidosis; P1: Significance vs controls; P2: Significance for a vs b for each variable.