The International Tinnitus Journal

Hvperinsulinemia: The Common Denominator Of Subjective Idiopathic Tinnitus And Other Idiopathic Central And Peripheral Neurootologic Disorders

Background:  Hyperinsulinemia as determined by glucose / insulin tolerance identified an etiologic relationship to idiopathic Meniere's disease. This was subsequently concurred with internationally by others. Proctor identified hyperinsulinemia in Subjective Idiopathic Tinnitus (SIT).Hyperinsulinemia and migraine with tinnitus and/ or vertigo were also correlated. Methods: Based upon 15,000+ 100g glucose / insulin tolerances, the presence of hyperinsulinemia as determined by radioimmunoassay became defined and statistically confirmed. Fasting insulin levels greater than 30 /J.U / mL (180 pmol/L) or the sum of the 2nd and 3rd hour insulin levels greater than 60 /J.U /mL (360 pmol/L) following 100 g glucose load identified and thereby defined hyperinsulinemia. The statistical database affirmed hyperinsulinemia with or without hyperglycemia as the sine qua non of the noninsulin-dependent diabetic state. Hyperinsulinemia was further statistically affirmed as the early metabolic marker in carbohydrate metabolism, preceding hyperglycemia. Results: Updegraff, Mangabeira-Albernaz, Fukuda, Proctor, and Malavasi-Ganan<;a independently identified and concurred that hyperinsulinemia was the major etiologic factor in up to 84% to 92% of their idiopathic neurootologic disorders. Their cases included tinnitus, vertigo, hypoacusia, and classical Meniere's disease. Updegraff identified hyperinsulinemia in his migraine studies. Independently the investigations reported dramatic relief and sustained therapeutic response to medical nutritional therapy compliance unequaled by other modalities. Conclusions : Hyperinsulinemia is a dynamic process definable by glucose / insulin tolerance. It is a very cost-effective office and/ or outpatient procedure. Hyperinsulinemia with or without hyperglycemia is the major metabolic marker with diagnostic and therapeutic relationship to SIT and other idiopathic neuro-otologic disorders. The unequaled therapeutic responses of SIT and other hyperinsulinemia idiopathic neuro-otologic disorders to medical nutritional therapy compliance mandates the earliest possible identification of hyperinsulinemia.