A study of auditory brainstem evoked responses in type 1 and type 2 diabetes mellitus patients with normal hearing
Keywords:Diabetes mellitus, Auditory brainstem responses, Central neuropathy
Background: Diabetes mellitus (DM) is one of the most common metabolic disorders with millions of cases world-wide. Its effect on functioning of the central nervous system (CNS) and the peripheral nerves is a matter of current neurological research. Our study aimed to find out changes in auditory brainstem responses if any, in patients with type 1 and type 2 DM patients with apparently normal hearing.
Methods: 50 cases each of type 1 and type 2 diabetic patients with normal hearing were chosen along with 50 healthy controls. Pure tone audiometry and brainstem evoked response audiometry (BERA) was performed in all cases. The BERA results were interpreted for the latencies of waves I, II, III, IV and V and inter-peak latencies I-III, I-V and III-V.
Results: Significant delay in absolute latency of wave I, III, IV, V and inter-peak latencies I-V and III-V was seen in Type 1 diabetic patients. In Type 2 diabetic patients, latencies of waves I, II, III, IV and V and inter-peak latencies I-III, I-V and III-V were significantly delayed. There was no statistically significant difference in latency delay between type 1 and type 2 DM. No relation was found with the duration of DM.
Conclusions: BERA is a non-invasive and easy to perform test that can detect minor CNS changes and can be used to detect peripheral (auditory nerve) and central neuropathy in diabetics even in absence of clinical signs and symptoms of deafness.
Powers AC. Diabetes Mellitus. In: Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J, eds. Harrison's principles of internal medicine. 18th ed. New York, NY: Mc Graw Hill Professional; 2011: 2968-3002.
Toth F, Varkonyi TT, Rovo L, Lengyel C, Legrady P, Jori J, et al. Investigation of Auditory Brainstem Function in Diabetic Patients. Int Tinnitus. J 2003;9(2):84-6.
Okhovat SA, Moaddab MH, Okhavat SH, Al-Azab AA, Saleh FA, Oshaghi S, et al. Evaluation of hearing loss in juvenile insulin dependent patients with diabetes mellitus. J Res Med Sci. 2011;16(2):179-83.
Gupta R, Aslam M, Hasan SA, Siddiqi SS. Type-2 diabetes mellitus and auditory brainstem responses-a hospital based study. Indian J Endocrinol Metab. 2010;14(1):9-11.
Misra UK, Kalita J. Brainstem auditory evoked potentials. In: Clinical Neurophysiology. 2nd ed. New Delhi, India: Elsevier; 2006: 329-345.
Donald MW, Bird CE, Lawson JS, Letemendia FJ, Monga TN, Surridge DH, et al. Delayed auditory brainstem responses in diabetes mellitus. J Neurol Neurosurg Psychiatry. 1981;44(7):641-4.
Fedele D, Martini A, Cardone C, Comacchio F, Bellavere F, Molinari G, et al. Impaired auditory brainstem-evoked responses in insulin-dependent diabetic subjects. Diabetes. 1984;33(11):1085-9.
Lisowska G, Namysłowski G, Morawski K, Strojek K. Early identification of hearing impairment in patients with type 1 diabetes mellitus. Otol Neurotol. 2001;22(3):316-20.
Durmus C, Yetiser S, Durmus O. Auditory brainstem evoked responses in insulin-dependent (ID) and non-insulin-dependent (NID) diabetic subjects with normal hearing. Int J Audiol. 2004;43(1):29-33.
Fawi GH, Khalifa GA, Kasim MA. Central and Peripheral Conduction Abnormalities in Diabetes Mellitus. Egypt J Neurol Psychiat Neurosurg. 2005;42(1):209-21.
Alam MN, Jalvi R, Rangasayee R, Katarkar A, Jain A. An evaluative study of auditory brain-stem evoked response patterns in diabetic subjects with normal hearing. Int J Diabetes and Metab. 2011;19:113-5.
Verma A, Bisht MS, Ahuja CK. Involvement of central nervous system in diabetes mellitus. J Neurol Neurosurg Psychiatr. 1984;47(4):414-6.
Sharma R, Gupta SC, Tyagi I, Kumar S, Mukherjee K. Brain Stem Evoked Responses in patients with Diabetes Mellitus. Indian J Otolaryngol Head Neck Surg. 2000;52(3):223-9.
Forogh B, Zeinolabedini R, Akbari M, Mianehsaz E. Evaluation of hearing in middle-aged patients with diabetes mellitus Type 2. J Biomed Sci Eng. 2013;6:16-9.
Talebi M, Moosavi M, Mohamadzad NA, Mogadam R. Study on brainstem auditory evoked potentials in diabetes mellitus. Neurosciences (Riyadh). 2008;13(4):370-3.
Chaudhary S, Karki P, Bajaj BK, Patel S. Evaluation of Brainstem Auditory Evoked Potential in Diabetics. J Univ College Med Sci. 2014;1(2):8-12.
Abdulkadiroglu Z, Kaya A, Gonen S, Ithan N. Brainstem Auditory Evoked Potentials in Patients with Type 2 Diabetes Mellitus. Turkish J Endo Metabol. 1999;1:29-32.
Seidl R, Bernert G, Birnbacher R, Freilinger M, Hauser E, Schober E. Brainstem auditory evoked potentials and visually evoked potentials in young patients with IDDM. Diabetes Care. 1996;19(11):1220-4.