Hearing loss may be an overlooked topic of discussion in the diabetes community, but it’s certainly an important topic. Research has shown that hearing loss is twice as common in people with established diabetes, and people with prediabetes have a 30% higher rate of hearing loss than those without.
“Hearing loss is more common in people with diabetes,” says Dr. Shelly Borgia, Doctor of Audiology and Founder of NYC Hearing Associates, PLLC. “The organ of hearing depends on good circulation and if circulation is compromised, your hearing can be affected.”
Read on to learn more about hearing loss, causes and risk factors, treatment and prevention for people with diabetes.
Hearing loss and diabetes
Diabetes is a general term for a disease that impairs the body’s ability to metabolize glucose (sugar) due to insulin deficiency, insulin omission, insulin resistance, or a combination. The most common types of diabetes are type 1 and type 2. The association between hearing loss and diabetes does not appear to be influenced by the type of diabetes.
Type 1 diabetes is an autoimmune disease in which the body mistakenly attacks cells in the pancreas that make insulin. Insulin is a hormone with many functions, and it is essential for bringing sugar into our cells to use as a source of energy. People with type 1 diabetes must take insulin by injection or infusion to maintain normal blood sugar levels.
Type 2 diabetes is a progressive disease and the most common type of diabetes. Type 2 diabetes develops when the body becomes less sensitive to insulin and/or does not produce enough of it. For many people with type 2 diabetes, their disease can be managed through lifestyle changes like diet and exercise. However, depending on glucose levels and other health conditions, medication may also be needed.
The discussion around the link between diabetes and hearing loss has been around for decades, but the research to find out why this link exists is complicated. Many factors contribute to hearing loss in people with diabetes.
The causes of hearing loss in people with diabetes are complex. Human and animal studies suggest both cochlear (inner ear that translates sound) and nerve loss is linked to small vessel disease (microangiopathy), oxidative stress and cell death (also called glutamate excitotoxicity).
Reduced blood supply or circulation problems can also affect hearing. One of the most common types of hearing loss in people with type 2 diabetes is called presbycusis, a permanent and progressive sensorineural hearing loss.
Hearing loss is more common with age, and prolonged exposure to loud noises can also increase the risk of hearing loss. Hyper and hypoglycemia (both side effects of diabetes) can also increase the risk of hearing loss by damaging the nerves.
In the Diabetes Control and Complications Trial Epidemiology of Diabetes and Complications (DCCT/EDIC) cohort, among participants with type 1 diabetes, for every 10% increase in hemoglobin A1c (average blood glucose over three months), there is had a 32% increase in impaired speech perception and a 19% increase in high-frequency hearing loss. So there seems to be a correlation between glycemic control and hearing loss.
Other research suggests that certain types of medications prescribed to people with diabetes, such as aspirin, specific antibiotics, and blood sugar-lowering medications, may contribute to hearing loss.
Additionally, other health conditions can contribute to hearing loss. Some of them include diabetic retinopathy and nephropathy; these microvascular complications of diabetes affect the small vessels of the body.
Age is one of the main risk factors for hearing loss. About 1 in 3 people between the ages of 65 and 74 have hearing loss, and almost half of people over 75 have difficulty hearing. The National Institute of Deafness and Other Communication Disorders reports that age is the strongest predictor of hearing loss in adults between the ages of 20 and 69, with the greatest amount of hearing loss in the age group of 60 to 69 years.
Other risk factors include gender, race, economic status, and other health conditions. Men are almost twice as likely as women to have hearing loss in adults aged 20-69.
The researchers collected data from 536 participants, ages 20 to 69, with diagnosed or undiagnosed diabetes who took hearing tests between 1999 and 2004 as part of the National Health and Nutrition Survey ( NHANES). They found that there was a greater likelihood of hearing loss for older, non-Hispanic white, male, or low-income people. People with diabetes with low high-density lipoprotein (HDL), a history of coronary artery disease, symptoms of peripheral neuropathy, or those who report poor health also had a greater likelihood of hearing loss.
Whether or not glycemic control, hyperglycemia and hypoglycemia increase the risk of hearing loss is in conflict. Some research suggests that poor glycemic control (high or low blood sugar) is associated with an increased risk of hearing loss, while other researchers have found no association between hearing loss and duration of high blood sugar and diabetes.
Hearing loss may come on slowly, and family members may notice changes in your hearing before you do. Hearing problems can impact your balance and quality of life by making it harder to hear in noisy places and causing others to repeat themselves.
If you are concerned about your hearing or that of a loved one, you should consult an audiologist. An audiologist will perform a complete checkup to assess your hearing and balance. They can also help you with treatment options.
Dr. Borgia recommends getting a hearing test at any age. “It’s important to know your personal hearing level. At a minimum, everyone aged 50 and over should have their hearing tested because 1 in 10 people are affected by age-related hearing loss.”
Treatment for hearing loss should be individualized and will depend on the type of hearing loss and its severity. Some treatment options include:
- Hearing aids
- Tinnitus Masks
- Vestibular repositioning
People with diabetes can prevent hearing loss by:
- Keep their blood sugar under control
- Maintain a healthy diet
- Move your body regularly
- Get annual exams
- Assess your medications
- Refrain from exposure to loud noise
A study suggests that adopting a Mediterranean style of eating can help prevent hearing loss.
When to See a Health Care Provider
If you have diabetes and have never seen an audiologist, you should have a basic evaluation of your hearing and a follow-up every year or two for re-evaluation. Additionally, “Anyone who has had concerns about their hearing, such as fullness, tinnitus, noise exposure, or pain, should see an audiologist or otolaryngologist,” says Borgia.
A word from Verywell
There are many reasons why people with diabetes can develop hearing loss, some are within your control and some are not. But the good news is that hearing loss can be prevented and treated.
Maintaining good blood sugar control has an impact on your overall health and can reduce your risk of all diabetes complications. If you need help keeping your blood sugar in a healthy range, contact your medical team and consider meeting with a certified diabetes care and education specialist. They can help you create an individualized treatment plan that addresses lifestyle modifications such as diet and exercise, as well as medication management, prevention and treatment of high blood sugar and low blood sugar. .
If you are 50 or older and have never seen an audiologist, you can schedule a screening. Even if you don’t think you have any hearing problems, early detection can help with prevention.
Frequently Asked Questions
What happens if diabetes is not treated?
Any type of diabetes must be treated to prevent short-term and long-term complications. Hyperglycemia (or high blood sugar) disrupts small and large blood vessels and contributes to disorders throughout the body. In people with type 1 diabetes, high blood sugar can cause a medical emergency called diabetic ketoacidosis. Diabetic ketoacidosis is life-threatening if left untreated.
Is the hearing loss reversible?
Hearing loss occurs when part of the ear or the nerves that transmit sound information to your brain don’t work properly. Damage to the inner ear or auditory neural system is usually permanent, but some types of hearing loss can be temporary. It depends on which part of the ear is affected. The key to maintaining your hearing is prevention.