Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role of known contributing factors such as age, gender and hypertension’. Another aim was to identify any potential mediating relationship between type diabetes, hypertension and BPPV. A thorough search of case notes over a six-year period identified patients who presented with vertiginous disorders: 699 had type 2 diabetes and 3222 patients did not. BPPV was the commonest vertiginous diagnosis in the diabetics (46%) and non-diabetics (37%). The difference between the two was surprisingly statistically significant (p < 0.001). Using regression analysis, age, sex, race and hypertension were the significant variables predictive of BPPV. BPPV was higher with increasing age, females, African-Americans and Asians compared to Caucasians. In all age groups, hypertension was present in 86.8% of individuals with type 2 diabetes, compared to 37.2% with BPPV without type 2 diabetes. Further analysis showed that 42% of the association between type 2 diabetes and BPPV was mediated through hypertension. The risk of BPPV was higher in diabetics if there was concurrent hypertension. In one sense the findings are not surprising. The authors concluded that “since hypertension, diabetes and BPPV can independently cause dizziness, it is important for the clinician to examine all potential causes of dizziness carefully. Asking specific questions, to determine if BPPV could be a source of the dizziness, may help with early diagnosis and treatment”. What is not clear from the study are the duration of diabetes and hypertension and whether the two conditions were well or poorly controlled.

Retrospective data suggests that the higher prevalence of benign paroxysmal positional vertigo in individuals with type 2 diabetes is mediated by hypertension.
D’Silva LJ, Staecker H, Lin J, et al.
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Victor Osei-Lah

Bournemouth, UK.

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