Diabetes Mellitus as a Risk Factor in Recurrent Vestibular Disorders: An Update.

Background/Objectives: Diabetes mellitus (DM) has been proposed as a potential risk factor for vestibular dysfunction, although the evidence remains heterogeneous. This review was prompted by the increasing recognition in clinical practice of a frequent coexistence between DM and recurrent vestibular disorders. It aims to examine the most recent available literature investigating the association between DM and the most common causes of recurrent vestibular disorders, thereby providing clinicians with additional insights for early diagnosis and risk stratification. Methods: A systematic review was conducted according to PRISMA guidelines with SWiM-based narrative synthesis. PubMed, Scopus, and Google Scholar were searched for studies (2016-2026) including adult diabetic patients with vestibular disorders. Risk of bias was assessed using NOS, RoB2, and JBI tools. Results: Twenty-nine studies met the inclusion criteria, but only nineteen were focused explicitly on recurrent vestibular disease. Diabetes was consistently associated with higher prevalence and recurrence of benign paroxysmal positional vertigo (BPPV), more persistent vestibular symptoms, and worse balance outcomes. Associations with other recurrent vestibular disorders was scarce and high heterogeneity limited quantitative synthesis. Conclusions: The available literature suggests that DM increases the vulnerability of the vestibular system in BPPV cases while data regarding other vestibular disorders, including VM and MD, are still limited. More prospective studies investigating the link between diabetes and recurrent vestibular disorders are needed, particularly through specific indicators of evolutionary picture of diabetes.