03/10/2026
Drop your guess in the comments! 👇
.
.
ANSWER: E) All of the above
Diabetes can lead to dietic neuropathy and chronic inflammatory polyneuropathy, meaning the long nerves outside of the brain and spinal cord are impacted...
i.e. the VAGUS nerve can take a hit!
Here's how these neuropathies can impact swallowing:
👉Slow gastric emptying (gastroparesis) is common in diabetes, which can disrupt the timing and coordination of the entire swallow.
👉Hyperactivity of the cricopharyngeus muscle and upper esophageal sphincter can make it harder for food and liquid to pass from the throat to the esophagus.
👉Decreased pharyngeal sensation means patients may not feel residue or aspiration, increasing risk for silent aspiration and pneumonia.
👉Decreased vocal fold adduction (from chronic inflammatory polyneuropathy) can lead to voice changes and reduced airway protection.
Diabetes impacts nerve health, muscle coordination, and sensory feedback.
If you’re seeing unexplained swallowing or voice changes in a patient with long-standing diabetes, neuropathy could be the missing link. An instrumental swallow exam is warranted!
📌Save this post for your next diabetes consult
REFERENCES
Borgström, P. S., Olsson, R., Sundkvist, G., & Ekberg, O. (1988). Pharyngeal and oesophageal function in patients with diabetes mellitus and swallowing complaints. The British journal of radiology, 61(729), 817–821. https://doi.org/10.1259/0007-1285-61-729-817
-
George, N. S., Rangan, V., Geng, Z., Khan, F., Kichler, A., Gabbard, S., Ganocy, S., & Fass, R. (2017). Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia. Journal of clinical gastroenterology, 51(10), 890–895. https://doi.org/10.1097/MCG.0000000000000894
-
Ravi, R. and Gunjawate, D.R. (2019), Effect of diabetes mellitus on voice: a systematic review. Pract Diab, 36: 177-180. https://doi.org/10.1002/pdi.2240
-
Zilliox, L. A., Chadrasekaran, K., Kwan, J. Y., & Russell, J. W. (2016). Diabetes and Cognitive Impairment. Current diabetes reports, 16(9), 87. https://doi.org/10.1007/s11892-016-0775-x