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What is the prevalence of diabetes and hearing loss?
In a 2008 National Health and Nutrition Examination Survey (NHANES) analysis to determine whether hearing impairment is more prevalent among US adults with diabetes, the incidence of hearing loss in diabetes was approximately 30%. Hearing loss was also found to be twice as common in adults with diabetes compared to those who do not have the disease.
Moreover, adults with pre-diabetes have been found to have a 30 percent higher rate of hearing loss compared to those with normal blood sugar tested after an overnight fast.
Further evidence of the connection was found by researchers who analyzed data from 13 studies involving 20,104 participants. They discovered that people with diabetes were more likely to have hearing loss than those without the disease, regardless of their age.
Given that the number of adults diagnosed with diabetes in the last 20 years has more than doubled, awareness of the association between diabetes and hearing loss is key for people with diabetes and physicians in order to monitor any changes in hearing and treat any associated hearing loss in the early stages, limiting the impact on daily life.
How might diabetes cause hearing loss and tinnitus?
According to CDC, over time, high blood sugar levels from diabetes can cause damage to small blood vessels and lead to nerve damage that affects many parts of the body, including your hands, feet, eyes, kidneys, and even your ears. In fact, it’s possible that vascular-related problems may be a root-cause of many of the chronic illnesses associated with hearing loss, including diabetes.
Kathy Dowd, AuD, founder of The Audiology Project (TAP), a non-profit organization that gathers research and advocates for clinical audiology guidelines for patients with diabetes told HearingTracker, “The disruption of small blood vessels and decline of the nervous system affects both hearing and balance organs.”
New Jersey audiologist Robert M. DiSogra, AuD, who writes and lectures on a variety of hearing loss topics notes, “The hearing loss is usually gradual and not complete, generally affecting the higher frequencies which give words clarity.”
Those affected may first start to notice words becoming muffled or begin to experience tinnitus (ringing in the ears). Often, it is family members of the person with hearing loss who notices it first.
The inner ear has two main parts: the hearing organ (cochlea) and the balance organ (semicircular canals). Research shows both can be negatively affected by cardiovascular issues and diabetes.
How might diabetes affect balance?
Though less studied, more evidence is emerging about the effect of diabetes on the balance system.
“The auditory system is a two-part system of hearing and balance.” explains DiSogra. “So, if there’s an issue with hearing, there could be an issue with balance.”
According to Dowd, disruption to other parts of the body due to diabetes can contribute to a tsunami of effects, increasing the risk of falls and injury: “In addition to the vestibular (balance) effects. You’re losing your eyesight. So, you don’t see obstacles in your path. And you have foot neuropathy (nerve damage in your feet), so you don’t feel if you’re stepping on something uneven.”
A 2010 NHANES study which investigated the relationship between diabetes and vestibular function found a higher prevalence of vestibular dysfunction in patients with diabetes. For those with diabetes and vestibular dysfunction, the risk of falls was found to be twice as high.
Can diabetes medications impact hearing?
To determine whether diabetes medications may be ototoxic (i.e., potentially cause damage the ear), Dr. Michelle McElhannon, PHARM.D, a clinical pharmacist in Georgia, and DiSogra have recently collaborated on a review for TAP. They looked at all FDA-approved medications for diabetes management, to assess any potential side effects on hearing or balance.
Some medications were identified as having possible side effects such as blurred vision and lightheadedness, which could affect balance. Others were associated with ear congestion and tinnitus. However, DiSogra told HearingTracker, “Out of all FDA approved drugs [at time of review], none of them can exacerbate a hearing loss.”
The list of medications can be found on the Education Materials page of TAP.
The CDC recommends all people with diabetes get an initial baseline hearing test at diagnosis followed by annual hearing tests. In addition, periodic hearing screening tests via apps and the internet can also help tip you off to the need for a full diagnostic hearing test.
Should you get your hearing checked if you have diabetes?
Due to the connection between diabetes and hearing loss, CDC recommends you get a baseline hearing test at the time you’re diagnosed — whether you feel there is a hearing problem or not. Every year after, you are advised to have another updated hearing test to monitor any changes.
What is the value of monitoring your hearing when you have diabetes?
“First of all, recognize that hearing loss is common in people with diabetes,” assures DiSogra. “Then you need to get your hearing evaluated.” He recommends making an appointment with an audiologist who can carry out all the necessary tests to check your hearing and then monitor it over time.
Loud power tools, music, lawnmowers and snowblowers, firearms, and even some household appliances like vacuum cleaners can emit very high noise levels. Having diabetes makes it even more important to wear earplugs and/or earmuffs.
Helpful tips for conserving your hearing if you have diabetes
The following steps can help you manage your diabetes and limit the risk of developing hearing loss:
Protect your ears
Christopher Spankovich, AuD, PDH, MPH, Associate Professor, Director of Clinical Research, and Clinical Audiologist at the University of Mississippi Medical Center (UMC), emphasizes the importance of understanding ways to preserve your hearing health. “The patient should be counseled in the use of hearing protection during exposure to very loud noises,” he states. “They should also recognize that if they’re on ototoxic medication, they need to have careful monitoring.”
A final note about diabetes and hearing loss
Our hearing plays a big part in the way we interact with the world and with our loved ones. Hearing loss is associated with loneliness and social isolation, an increased risk of depression, and even cognitive decline. Yet, hearing loss can be easily treated.
