Diabetes and Hearing Loss

Why Diabetes Can Cause Changes in Your Hearing

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Female doctor helping male patient with hearing aid in doctors office
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Diabetes is a chronic disease that causes elevated blood sugar levels. The prevalence of diabetes has been increasing in the United States and currently affects somewhere around 30 million Americans.

While the exact pathology of high blood sugar and hearing loss is not entirely understood studies do show that hearing loss is more likely to occur among individuals with diabetes.

In fact studies suggest that if you have diabetes you are twice as likely to develop hearing loss than someone who has normal blood sugars.

Diabetes and Hearing Loss

There are several different mechanisms by which diabetes may contribute to hearing loss. 

One way that diabetes may affect hearing has to do with lipid (fat) metabolism. When your body doesn't produce enough insulin to utilize glucose you start to break down fats at a higher rate than normal. This results in high blood lipid levels.

High levels of lipids in the blood can negatively affect blood vessels, a condition called arteriosclerosis. Narrowed or even blocked blood vessels are unable to adequately supply your nerves with blood and they become malnourished. This is what causes diabetic neuropathy. Nerves in all parts of your body may be affected by this including the nerves that are involved in hearing. Damaged nerves may be unable to relay proper sound signals to your brain for interpretation.

Changes in blood flow due to high lipids and glucose levels in the blood (sometimes referred to as microcirculation disorder), can also affect the cochlea—a structure in the inner ear that is necessary for hearing. 

It is also possible that high lipid levels in the blood lead to lipid deposits in the tiny hair cells of the cochlea.

The cochlea also requires large amounts of glucose to produce the energy it needs to function which can be problematic with diabetes mellitus.

Studies in rats have also shown that other inner ear structures may be damaged in diabetes mellitus including changes to outer hair cells and spiral ganglion cells and nerve fibers. Loud noise exposure seems to compound these morphological changes.

Research has also shown that individuals with other complications of diabetes such as cardiovascular disease, peripheral neuropathy or encephalopathy or more likely to experience hearing loss than individuals who do not have complications of their diabetes. 

Another hypothesis is that gene mutations that predispose a person to develop diabetes may also contribute to hearing loss. There is a condition called MIDD (maternally-inherited diabetes and deafness).

It can also be noted that some research indicates that hearing loss is more prevalent in individuals with type 2 diabetes than type 1 diabetes. However, confounding factors may play a role.

For example, a greater percentage of the population has type 2 diabetes and they usually develop the condition later in life. Since you are more likely to develop hearing loss the older you get it makes sense that older people with diabetes would be more likely to suffer from hearing loss than their younger counterparts.

Symptoms

Some studies suggest that if you have diabetes (especially type 2 diabetes)  you are more likely to suffer from high-frequency sensorineural hearing loss. Low and mid frequency hearing loss also occurs. Symptoms may include:

  • Difficulty following conversations, particularly in noisy environments or when the conversation involves more than two people
  • Asking people to repeat themselves often
  • Tinnitus (ringing in the ears)
  • Because hearing loss may be high frequency in nature you may find yourself having a more difficult time understanding women or small children

Symptoms of hearing loss can come on so gradually that you may not even notice them until someone close to you points them out.

Diagnosis

If you have diabetes you may need to have your hearing checked more often. Let your healthcare provider know that you are concerned about diabetes and hearing loss to make sure it is on her radar. Your primary doctor can refer you to an audiologist who can perform the necessary hearing tests.

Prevention

The most important step you can take in preventing any complications from diabetes including hearing loss is to control your blood sugars. The blood test HbA1C is commonly used to monitor your levels.

Diet, exercise, and appropriate medications all play a role in keeping your blood glucose within normal range. Educate yourself and look for a doctor who is very knowledgable about this condition since the ability to keep blood sugars within normal levels varies greatly between individuals.

Taking other steps to protect your hearing such as avoiding loud noise exposure will help to protect your ears as well. Here are some tips for preventing hearing loss:

  • Wear ear plugs when operating loud equipment such as a lawnmower or other machinery
  • Do not listen to earbuds or high volume music for prolonged periods of time
  • Some medications including high doses of aspirin can damage your hearing
  • Learn how to maintain proper levels of earwax, never insert objects into your ears such as cotton swabs or bobby pins in an effort to remove earwax

Treatment

As previously mentioned controlling your diabetes is necessary for the best outcomes regarding not only hearing loss but complete health and well being. You will need to work with your healthcare provider and audiologist to find the best treatment options for your hearing loss.

Here are some common options that may improve your hearing and your quality of life:

  • Hearing aids may include options for behind the ear, in the ear, and hearing aids that fit discreetly inside the ear canal
  • Cochlear implants are reserved for very severe cases of hearing loss

Research regarding treatment with medications is ongoing. If hearing aids aren't a good option for you or if you need further treatment to manage your condition working with a speech therapist or other professional to learn to read lips and other communication skills may be beneficial

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