Assessment of swallowing disorders in patients with type 2 diabetes mellitus

Background Type 2 diabetes mellitus (T2DM) affects multiple body functions, including swallowing. However, the link between T2DM and oropharyngeal dysphagia remains largely unexplored. Objective This study aims to assess oropharyngeal dysphagia in individuals with T2DM and examine how it relates to disease duration and glycemic control. Methods A cross-sectional study was conducted on 30 patients with T2DM, recruited from the diabetes outpatient clinic at Eldemerdash Hospital, Cairo, with subsequent evaluations conducted at the Phoniatrics Clinic of Ain Shams University Hospitals and the Hearing & Speech Institute between September 2021 and September 2022. Each patient underwent a clinical examination along with a swallowing assessment using the Gugging Swallowing Screen (GUSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES). We analyzed the relationship between dysphagia symptoms, disease duration, glycemic control, and the type of diabetes medication used. Results The study included 16 males (53.3%) and 14 females (46.7%), aged between 40 and 70 years. The most frequently reported swallowing difficulty was trouble with biting and chewing (43.3%), followed by coughing and choking during or after eating (16.7%). GUSS identified a high risk of dysphagia in 30% of participants. FEES findings showed that patients with a longer duration of T2DM experienced more pronounced swallowing difficulties, including premature spillage, delayed swallowing reflex, and higher penetration-aspiration scale scores for liquids and semisolids ( p < 0.001). Additionally, the presence of food residue in the vallecular and pyriform sinuses was significantly linked to disease duration. Interestingly, glycemic control had only a limited correlation with swallowing impairment, suggesting that even well-managed T2DM patients remain at risk for dysphagia as the disease progresses. Conclusion Oropharyngeal dysphagia is a significant yet often overlooked complication in individuals with T2DM, particularly those with long-standing disease. Early screening and intervention are essential to prevent complications and improve patient outcomes. A collaborative approach involving endocrinologists and phoniatricians is recommended for better management and care.