Diabetes Related Vertigo: Causes and Treatment

Vertigo is an abnormal sensation of motion that can happen when a person is sitting still or when their movement through space is inaccurately sensed. Knowing where we are in space and how we are moving requires reliable information from five senses:

  1. Our vision orients movement by taking cues from vertical objects and the horizon.
  2. Our inner ear orients us to angular movements as we turn our head and to our acceleration as we move forward.
  3. Touch orients us as our weight presses us against things (e.g., feet to the ground, but to a chair).
  4. Proprioception detects the position of our neck and limbs as we move.
  5. Our hearing orients us to objects reflecting sound and to sound-emitting objects.

Any impairment of these senses can lead to an experience of vertigo, disequilibrium or dizziness. Medical issues, including diabetes and heart disease, can potentially disrupt the functioning of these senses through nerve damage or circulation impairment.


Vertigo and Disequilibrium

Spinning vertigo is when either the environment appears to be spinning or a person feels that they are spinning within the environment. Positional vertigo is a spinning sensation occurring after a person repositions their head. A spinning sensation is often caused by inner ear problems.

Disequilibrium is the sensation of an impending fall or the need for external assistance to maneuver from here to there. Some people describe a floating sensation or that the floor or room appears tilted. This can be an inner ear or other motion-sensory issues, or it can originate in the central nervous system.

All experiences of vertigo and disequilibrium should be reported to your physician. Treatment, which might bring resolution or involve lifestyle adjustments, will depend on discovering and addressing the cause or causes. For diabetes-related symptoms, a doctor might suggest physical therapy, new medication, eye surgery, a hearing aid or mobility aid.


Diabetes and Dizziness

Dizziness describes feelings of being lightheaded or sensing that one will faint. Individuals with diabetes may experience dizziness for several reasons:

  1. Hypoglycemia (low blood sugar) causes dizziness because the brain is not receiving enough glucose to function properly. The dizziness may be accompanied by sweating and confusion.
  2. Hyperglycemia (elevated blood sugar) can cause excessive urination, leading to dehydration. One symptom of dehydration is dizziness.
  3. Hypertension (high blood pressure) is a problem for some people with diabetes. Although it often occurs without obvious symptoms, people sometimes experience headaches, nausea or dizziness with elevated blood pressure.
  4. Low blood pressure can cause dizziness when the brain does not receive an adequate blood supply, especially when getting up from a sitting or lying position.
  5. Medications may have dizziness listed as a side effect, including some diabetes and cardiovascular medications.

Recurring and persistent dizziness should be reported to your doctor. Keeping a log of what occurred before the dizziness started, when the episode began, and how long it lasted can help your physician pinpoint the cause and prescribe a solution or treatment (e.g., diet change, med change).


Multi-sensory Vertigo or Dizziness

The elderly, especially those with diabetes, can develop multi-sensory vertigo, disequilibrium or dizziness. The combination of peripheral neuropathy, visual impairment, changes in joint mobility, and hearing or inner ear impairments can cause abnormal sensations related to movement.

Treatment might include learning to rely more heavily on intact senses, physical therapy or gait training, using a mobility device (e.g., cane, walker), wearing a cervical collar to limit head movement, or discontinuing use of bifocal lenses.

Sources: NCBI, Diabetes, Dana Foundation
Photo: Pixabay


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