Can Diabetes Cause Hearing Loss?

Diabetes is a chronic metabolic disorder that disrupts the body’s ability to metabolize food into usable energy properly. In simple terms, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make, leading to high levels of sugar or glucose in the blood. Without proper management, it may cause potential substantial damage to various parts of the body, such as the heart, kidneys, nerves, and eyes.

In the Philippines, diabetes is a growing health issue. By 2021 estimates, 4.3 million Filipinos have been diagnosed, yet a concerning 2.8 million were probably living with the disease unaware, revealing a significant public health challenge. The prevalence has since been on the rise, making it a silent epidemic that impacts millions of Filipinos and their families.

Given its widespread and often silent nature, many of the complications of diabetes can develop unnoticed. While issues with the heart, kidneys, and eyes are well-known, emerging evidence reveals another significant, often-overlooked connection: the link between diabetes and hearing loss.

This link is now a critical area of focus, showing how the effects of high blood sugar extend even to our ability to hear the world around us.

Understanding the Connection Between Diabetes and Hearing Loss

Data published by the U.S. Centers for Disease Control and Prevention (CDC) reveals a link between blood sugar levels and auditory health. The prevalence of hearing loss is doubled among those with diabetes, and for individuals with prediabetes, the rate is 30% higher than in the population with normal blood sugar.

This increased risk is primarily due to the impact of hyperglycemia on the body’s vascular and nervous systems. The inner ear’s delicate structures depend on these systems for a healthy blood supply and proper auditory function. For individuals with chronic hyperglycemia or prolonged high blood sugar, the integrity of their inner ear’s vital pathways is compromised, disrupting the ear’s function and contributing to the development of hearing loss over time.

Causes of Hearing Loss in People with Diabetes

The primary cause of hearing loss in people with diabetes is the adverse impact of high blood sugar on the inner ear’s intricate systems. To understand this, think of the inner ear as a sophisticated communication center containing thousands of tiny hair cells and a network of nerves. This entire system, which converts sound into signals for the brain, depends on a constant, nutrient-rich blood supply.

Chronic hyperglycemia disrupts this system by damaging the small blood vessels, a condition known as microangiopathy, which deprives the delicate hair cells of the oxygen they need to survive. Diabetes can also cause neuropathy or nerve damage, which can compromise the auditory nerve itself. When this nerve is damaged, the transmission of sound signals to the brain is broken. This dual impact means the brain fails to receive a clear message, leading to hearing problems.

While both Type 1 and Type 2 diabetes increase the risk, the prolonged exposure to high blood sugar often seen in long-term or poorly managed Type 2 diabetes puts individuals at significant risk. The cumulative vascular and nerve damage over the years can lead to a gradual but permanent decline in hearing ability.

Detecting Hearing Loss in People with Diabetes

The early signs of hearing loss linked to diabetes are frequently overlooked because the condition typically progresses slowly over time. The signs to watch out for include:

• Frequently asking others to repeat themselves.
• Difficulty following conversations, especially in noisy environments.
• Thinking that other people are mumbling.
• Needing to increase the TV or radio volume higher than others find comfortable.
• Experiencing tinnitus or the ringing or buzzing sound in the ears.

If you have diabetes and notice any of these symptoms, it’s essential to seek a medical evaluation or ask your doctor for possible referrals for a hearing evaluation. A comprehensive hearing test service can assess your hearing health. An audiologist may perform several tests, including:

• Pure-tone testing: This test identifies the quietest sounds you can hear at different pitches.
• Speech testing: This measures your ability to hear and understand conversational speech.
• Middle ear tests: These check how well the parts of your middle ear, like the eardrum, are working.
• Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE) tests: These advanced tests measure the response of the hearing nerve and the function of the inner ear hair cells, respectively.

Given the high risk, individuals with diabetes should consider making regular hearing tests a routine part of their healthcare, just like yearly eye exams. Prompt diagnosis is fundamental to managing the illness and mitigating subsequent progression.

Options for Diabetes-Related Hearing Loss

The type of hearing loss most commonly associated with diabetes is sensorineural hearing loss (SNHL), a condition in which damage is located in the inner ear or the nerve pathways to the brain. SNHL is a permanent condition because the damaged hair cells and nerve fibers cannot regenerate.

While there is no cure for the condition, it can be managed. Digital hearing aids are a common solution. These devices are designed to be inconspicuous and can be custom-programmed to amplify specific sound frequencies an individual struggles to hear, enhancing their ability to communicate and interact with their environment.

Most hearing aid centers in the Philippines work with professionals who can assist you in finding a device that addresses your specific needs and fits your lifestyle. Therefore, be sure to consult an audiologist to determine the particular nature of your hearing loss and explore suitable solutions.

Other options, typically for more severe cases, include:

• Cochlear implants: By working around the inner ear’s damaged hair cells, this device delivers electrical stimulation directly to the auditory nerve, prompting it to send signals that the brain interprets as sound.
• Communication strategies: Learning lip-reading or sign language can also be beneficial, as they provide alternative visual methods to supplement or replace sound.
• Managing blood sugar levels: While it will not reverse existing hearing loss, strict glycemic control is crucial for maintaining the remaining auditory function from additional harm.
• Bone Anchored Hearing Aid (BAHA): For those that have conductive or mixed hearing loss issue.
• Contralateral Routing of Signals (CROS): For those with unilateral or asymmetric losses wherein one ear cannot use a hearing aid.

Minimizing the Risk of Hearing Loss in People with Diabetes

For individuals with diabetes, protecting their auditory health is primarily achieved through comprehensive management of the disease. Management of your blood sugar levels to keep them within the target range is a key strategy for protecting the vascular and nervous systems throughout your body, including the delicate structures in your ears.

Some essential healthy lifestyle tips to consider include:

• Monitor your blood glucose: Consistent monitoring helps prevent periods of high blood sugar that could potentially affect the delicate nerves and blood vessels within the inner ear.
• Follow a diabetes-friendly diet: Following a diabetes-friendly diet—rich in non-starchy vegetables, lean proteins, and whole grains—is key to maintaining stable blood sugar levels and protecting the inner ear’s sensitive structures from glucose-related damage.
• Exercise regularly: Regular exercise improves blood flow throughout the body, ensuring the auditory system receives the oxygen it needs to maintain its function.
• Manage other health factors: Controlling blood pressure and cholesterol helps preserve the health of the blood vessels that supply the inner ear, preventing damage that can lead to hearing impairment.
• Avoid smoking: Smoking damages blood vessels and increases insulin resistance, which disrupts circulation and significantly raises the risk of developing Type 2 diabetes. For smokers, quitting is a crucial step in helping to prevent the hearing loss associated with both conditions, as it improves circulation by preventing the narrowing of blood vessels, thereby ensuring that the inner ear’s delicate structures receive adequate oxygen.
• Protect your hearing: This practice prevents direct, noise-induced damage to the ear’s sensory cells, thereby avoiding the dual impact of noise and disease that would compound the risk already posed by diabetes.

Finally, schedule regular hearing screenings. An annual hearing test can catch changes early, allowing you and your healthcare team to take action before the problem significantly impacts your quality of life.

A Proactive Plan for Your Hearing Health

It is essential to understand that developing hearing loss with diabetes is not inevitable. Although the condition can damage the sensitive nerves and blood vessels in the inner ear, you can influence this outcome. Taking decisive, proactive steps to manage your diabetes through consistent care and healthy lifestyle choices is the key to reducing the associated risks of hearing loss.

Regular hearing evaluations are a crucial part of prevention, enabling the identification of any changes that may occur. Prioritize your auditory health with the same diligence as other aspects of your diabetic care. Take control of your health today by consulting with your doctor and seeking guidance from audiology professionals.