I think the mechanism for Ménière's is that insulin makes the ear more permeable. So I have too much insulin (why?) and that causes my issues. Eventually it will lead to insulin resistance.
Why?
Because you produce too much insulin and you have an intolerance to sugars.
The nitty gritty of RH can be totally dependent upon your initial insulin response or hormonal response to what you eat.
My RH without control can't cope with carbs, sugar or any sugar with ose at the end of the word, bar a little bit of fructose.
My initial response of insulin is insufficient to cope.
So I get high blood glucose levels, and depending on the amount of carbs in that meal, I can in all honesty have what is termed a glucose dump. The symptoms of a sudden spike is because of the change in the balance of hormones, glucose and the speed in change.
If my bloods go above 7mmols (ish) again how high I go, and I can go into double figures for something like potatoes or glucose or some wheat or oat products, it also depends on what else you have with the carbs, which can vary with the protein and fats with it, because good fats will slow digestion. It's a fine balance.
So I am at the apex of my spike and my automatic response of hormones at that time is too much insulin (the overshoot) and within a couple of hours, sometimes longer, and because of the amount of insulin trying to find the glucose to convert into energy.
The blood is depleted of producing energy and of course the brain needs sufficient glucose to have brain function. A hypoglycaemic episode. Hence the hypo symptoms and possible health issues from too many hypos. Even passing out and needing hospital treatment.
The best treatment and prevention of hypos, is very similar to an allergy, when you have an allergy or as both of us are lactose intolerant, having milk would bring on an episode. And continuous episodes would definitely increase poor health. So you shouldn't eat or drink dairy or carbs or sugars. You do not want to live with the consequences of hypoglycaemia. Just avoid them.
As for insulin resistance, I just don't know.
I do know that inflammation and high circulating insulin can cause it. But so can other contributory factors. And even more into the science wether your cells, hormones, integrate for the balance to be as normal as it should be.
Regardless of how high your blood glucose levels go, the reason why you have episodes of hypoglycaemia.
And the best advice I can give is learn, explore, experience, and be positive in what you consider appropriate action you want to take. I can only give you my experience and how I control it.
And to emphasise my physical health is really good for a man of my age, only because I chose, (not the doctors, dieticians or endos) I chose to remove the foods that were killing me.
My best wishes.
Let us know how you get on.