![]() ![]() The regulation of glucose uptake and metabolism is one of the major actions of insulin, but not all tissues are subject to this function. Insulin is an anabolic polypeptide hormone with numerous roles at plasma membrane, cytoplasmic, mitochondrial, and genomic levels. A further delay has been observed for changes to cochlear microphonic amplitude of approximately 2 to 3 hours. Who reported that glucose levels in cochlear fluids parallel those in the blood, albeit with a delay of about an hour between the time of maximum concentration of glucose in cochlear fluids and maximum concentration in blood. The timeline for these pathophysiological effects may be related to the findings of Juhn and Youngs The reduction in DPOAEs observed by Zuma e Maia and Lavinsky was primarily limited to the more metabolically demanding basal portion of the cochlea approximately 60 minutes after induction of hypoglycemia. OAEs represent distortions and reflections of the inner ear related to the system's nonlinearity and amplification OHC integrity is critical to the presence and amplitude of OAEs. Gave sheep a bolus injection of insulin and showed reductions in distortion product otoacoustic emissions (DPOAEs). Experiments creating hypoglycemia reduce the endocochlear potential and cochlear microphonic, a receptor potential primarily generated by the outer hair cells (OHCs). This energy is required to maintain the large voltage gradient between the sensory receptors of the inner ear and the cochlear fluids, called the endocochlear potential. Glucose is the primary energy source for the cochlea. Role of Glucose and Insulin in the Cochlea Here we provide an overview of animal and human evidence of pathophysiological changes created by DM and its effects on auditory-vestibular anatomy and function. ![]() ![]() An even lesser understood complication of DM is the effect on the vestibular system. Recent investigations of the mechanisms underlying the association between hearing loss and DM suggest complex combined contributions of hyperglycemia, oxidative stress resulting in cochlear microangiopathy, and auditory neuropathy. Despite the growing research literature on the pathophysiology of DM-related hearing loss using various animal models and other human studies, knowledge of specific mechanism of the degenerative changes of the inner ear and/or auditory nerve is far from full elucidation. Most population-based investigations of hearing loss in persons with diabetes (PWD) have revealed a slow progressive, bilateral, high-frequency sensorineural hearing loss. The relationship between diabetes mellitus (DM) and the auditory/vestibular system has been investigated for more than a century. ![]()
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