Subclinical neural hearing alterations in school children with type 1 diabetes mellitus / Alteraciones neuroauditivas subclínicas en escolares con diabetes mellitus tipo 1

Background and objectives Evidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. Methods The study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). Results Significant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. Conclusion This study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control. (AU)

Justificación y objetivos La evidencia ha demostrado una relación de causa y efecto entre la diabetes mellitus tipo 1 y las disfunciones auditivas y cognitivas. Este estudio tuvo como objetivo investigar el efecto de la diabetes mellitus tipo 1 (DM1) en las funciones cognitivas y auditivas centrales en niños y adolescentes en edad escolar. Métodos La muestra del estudio estuvo constituida por 101 niños y adolescentes, 50 con DM1, de ambos sexos, con edades entre 7 y 18 años. Todos los participantes fueron seleccionados para una entrevista estructurada sobre la salud auditiva, conductual y cognitiva y la evaluación de los potenciales evocados auditivos del tronco encefálico (BAEP) y los potenciales relacionados con eventos (P300). Resultados Se observaron diferencias significativas en quejas de memoria (p=0,002) y atención (p=0,021) entre participantes con y sin DM1. En las respuestas BAEP, hubo diferencias entre las latencias de la onda III en el oído derecho (p=0,017) e izquierdo (p=0,019) y en las latencias de la onda V en el oído izquierdo (p=0,001) entre los grupos evaluados. Además, hubo asociación entre los hallazgos de PEATC y el control metabólico en el grupo de DM1 en el oído izquierdo en las ondas III (p=0,006) y V (p=0,005) y en el oído derecho en la onda V (p=0,026). No se observaron diferencias en las latencias de P300 entre los grupos evaluados. Conclusión Este estudio demostró la existencia de un hallazgo subclínico en la vía auditiva central, ofreciendo un mayor riesgo de alteraciones retrocollar, lo que puede ser consecuencia de un mal control metabólico. (AU)

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus.

BACKGROUND AND OBJECTIVES: Evidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. METHODS: The study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). RESULTS: Significant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. CONCLUSION: This study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Effects of type 1 diabetes mellitus on efferent auditory system in children and adolescents.

AIM: To investigate whether type 1 diabetes mellitus (T1DM) could affect the efferent auditory system by analyzing the relationship between the activation of the medial olivocochlear reflex with disease duration, metabolic control and age at time of diagnosis. METHOD: A total of 101 children and adolescents were evaluated. They were divided into two groups: 50 with T1DM and 51 without the disease. The participants answered a structured questionnaire containing questions about auditory complaints and were evaluated for tonal audiometry, tympanometry, acoustic reflex, otoacoustic emission by distortion product to evaluate the inhibitory effect of medial olivocochlear reflex (MOC). RESULTS: The participants with T1DM presented changed AR (increased or absent) at all the frequencies in both ears (p < 0.05) when compared with the group without the disease. No differences were found between the DPOAE amplitudes of the individuals with and without T1DM, in both ears at all the frequencies. There were significant differences in the activation of the MOC reflex between the groups with and without T1DM, the participants with T1DM presented the absence of the inhibitory effect of the DPOAE in the right and left ears, in the frequencies of 4000 Hz (p = 0.035/0.002respectively) and 6000 Hz (p = 0.033/0.031 respectively) and 8000 Hz (p = 0.007/0.001 respectively) when compared to the healthy group. Significant differences were also observed between the groups with and without T1DM (p < 0.05) for self-reported complaints of tinitus, difficulties with the perception of speech when there was noise and distraction with noise. No association was found between the hearing complaints and the audiological measurements obtained and disease time, metabolic control and age at the time of diagnosis. CONCLUSION: The findings suggest the presence of early auditory dysfunction of the efferent pathway in patients with T1DM.