Original Research
Does Type 2 Diabetes Mellitus Affect the Healing of Bell's Palsy in Adults?

https://doi.org/10.1016/j.jcjd.2017.10.055Get rights and content

Abstract

Objectives

Bell's palsy (BP) is defined as an acute facial weakness of unknown cause. Many factors affecting the healing of BP have been identified; 1 factor commonly considered relevant is the presence of type 2 diabetes mellitus. Our aim was to investigate the effects of diabetes on the healing of BP.

Methods

Sixty patients with BP were followed up for 1 to 3 years and were divided into 2 groups, those with and those without type 2 diabetes. All were prescribed prednisone (initially 1 mg/kg per day, with a tapered dose reduction) and acyclovir (200 mg orally every 4 h, 5 times daily, for 5 days). Their recovery times were compared.

Results

The healing times of the patients with and without diabetes did not differ.

Conclusions

Diabetes does not affect the severity, recovery rate from or healing of BP.

Résumé

Objectifs

La paralysie de Bell (PB) se caractérise par une faiblesse faciale soudaine dont la cause est inconnue. Parmi les nombreux facteurs qui nuisent à la guérison de la PB, le facteur généralement jugé pertinent est la présence du diabète sucré de type 2. Notre objectif était d'examiner les répercussions du diabète sur la guérison de la PB.

Méthodes

Nous avons suivi 60 patients atteints de PB durant 1 à 3 ans et les avons répartis en 2 groupes : les patients atteints du diabète de type 2 et les patients non atteints. Tous se sont fait prescrire de la prednisone (ordonnance initiale de 1 mg/kg par jour, suivie d'une réduction progressive de la dose) et de l'acyclovir (200 mg par voie orale toutes les 4 heures, 5 fois par jour, durant 5 jours). Nous avons comparé leur vitesse de guérison.

Résultats

La vitesse de guérison des patients diabétiques ou non diabétiques ne différait pas.

Conclusions

Le diabète n'a pas de répercussions sur la gravité, le taux de rétablissement ou la guérison de la PB.

Introduction

Bell's palsy (BP) (idiopathic unilateral facial paralysis) is the most common cause of acute nontraumatic peripheral facial palsy (1). The annual incidence of BP is 15 to 30 per 100,000 subjects, and equal numbers of males and females are affected 1, 2.

Approximately 70% of patients with BP recover completely without any treatment (3); with treatment, the rate rises to 90% (4). Many factors have been suggested as contributors to the healing process of BP. The most remarkable of these factors is diabetes. There is a common belief that diabetes affects the healing process of BP negatively. Although a relationship between diabetes and BP has been suggested, controlled studies are few in number. We explored whether diabetes affects the healing of BP.

Section snippets

Methods

This was a retrospective case-control study approved by our ethics committee (#2015-107-04/11). The study was conducted in an otolaryngology clinic between October 2012 and October 2014. We enrolled 60 patients who complained of facial paralysis and were diagnosed with BP; they visited our clinic regularly during the first week after diagnosis. Each patient underwent a complete ear, nose and throat examination, a neurologic examination, routine blood testing (including blood sugar and glycated

Results

The patients with diabetes were between 47 and 76 years of age (mean, 62.8±8.79 years). The patients without diabetes were 25 to 70 years of age (mean, 47.5±13.11 years); the mean age differed significantly in the 2 groups (p<0.001). The group with diabetes contained 12 (40%) women and 18 (60%) men; the group without diabetes included 16 (53.3%) men and 14 (46.6%) women. The recovery times did not differ in the 2 groups (p=0.438). We found no relationship between age and recovery time

Discussion

A number of factors supposedly affecting the prognosis of BP have been studied; they include age, sex, the side affected, hypertension, hypercholesterolemia and diabetes. The most controversial of these factors is diabetes. Takemoto et al found an association between diabetes and lack of recovery (6). Kanazawa et al found that although the healing process of patients with diabetes was similar to that of those without diabetes for the first month, healing was notably slower in patients with

Results

Our study had certain limitations. Our patient numbers were low, and the 2 groups differed in terms of mean age. To minimize this imbalance, we included only the oldest patients without diabetes. However, further work with more patients and groups that are better balanced in terms of age is required.

Conclusions

Diabetes did not significantly affect the severity or healing rate of BP or the recovery rate. A possible influence of steroid therapy on BP development in patients with diabetes should be considered; such patients should be closely monitored.

Author Disclosures

Conflicts of interest: None.

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