Hearing Loss: The Silent Complication of Diabetes

10/24/22

Diabetes, a chronic condition defined by the body’s inability to produce or utilize insulin properly in response to elevated blood glucose, is widely known for causing complications, including heart disease, kidney disease, and vision impairment. But recent research links diabetes to another potentially disabling yet under-recognized complication: hearing loss.

While studies examining the underlying science of diabetes-related hearing loss are ongoing, there is enough research available to suggest a relationship between diabetes and hearing impairment and to create guidelines that clinicians can follow to identify and manage this concern.

Prevalence and Causes

In a study funded by the National Institutes of Health, people with diabetes were observed to suffer hearing loss at twice the rate of the general population. Results also indicated that people with pre-diabetes were 30% more likely to experience hearing impairment than those with fasting blood sugar within the normal fasting range.[1]

Diabetic hearing loss may be rooted in damage to the inner ear’s nerves and blood vessels. High blood sugar levels put patients at risk for diabetic neuropathy. Neuropathy typically impacts a diabetics legs and feet, but it can also affect other nerves in the body, including those in the inner ear. Additionally, low blood sugar can impair the way that nerve signals leave the inner ear and reach the brain.[2]

As high and low blood sugar extremes may be responsible for hearing loss among diabetics, maintaining stable blood glucose levels is key to preserving hearing health.

Detection and Treatment

Like many of the well-documented complications of diabetes, hearing loss may occur slowly over time. But while patients are routinely monitored for signs and symptoms of worsening diabetes through laboratory tests and primary care checkups, they may not be receiving necessary acoustic screenings or hearing care.

The link between hearing loss and diabetes allows audiologists to work with primary care clinicians and other healthcare professionals in treating diabetics. Audiologists can serve as valuable members of a diabetics multi-disciplinary wellness team by providing hearing screenings upon diagnosis and regular auditory exams. They can play a pivotal role in preventing or mitigating diabetic hearing complications by testing for and documenting auditory changes and offering device fittings if necessary.

Preventing Further Hearing Loss

Clinicians can also urge diabetics to take precautions to protect themselves against preventable hearing loss from other causes. These include:[3]

  • Avoiding loud noises: Urge patients to keep the volume down at home, work, and leisure activities. If sound reduction is not possible, recommend using hearing protection such as earplugs or earmuffs.
  • Awareness of ototoxic medications: Discuss with patients any medications they may be taking that can cause temporary or permanent hearing loss (including medication prescribed for diabetes). Make sure they understand the risks and possible alternatives.
  • Smoking cessation: Inform patients that nicotine, as well as secondhand smoke, is known to cause irreversible damage to the hair cells of the inner ear.

Hearing loss can be a debilitating complication of diabetes. But a diabetics can avoid or prevent the worsening of diabetic hearing loss and maintain a good quality of life through proper disease management, a healthy lifestyle, regular visits with a care team, and healthy hearing habits.

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[1] https://www.nih.gov/news-events/news-releases/hearing-loss-common-people-diabetes
[2] https://www.cdc.gov/diabetes/managing/diabetes-hearing-loss
[3] https://nyulangone.org/conditions/hearing-loss/prevention