If you find yourself or a liked one often saying, “What did you say?” or “Speak up!” hearing loss might be the offender. Research has shown that individuals with diabetes are twice as most likely to experience hearing loss as those without diabetes, recommending that it might be a problem of the disease.
Hearing Loss and Diabetes Connection
While diabetes care includes regular tracking of health, whether it’s checking blood sugar or having a yearly dilated eye examination, hearing tests are frequently neglected, states Marilyn Enock, AuD, CCC-A, a Pittsburgh audiologist.
“Physicians ought to refer patients with circulatory issues, no mattertheir age, to an audiologist,” she states. “I see people who are 85 or 90 years of ages, and they’ve never had a hearing screen. It’s crucial to have a baseline.”
The Listening Link
Although existing research has drawn no firm conclusions about any association between diabetes and hearing problems, professionals believe there might be a relationship. Circulatory problems, such as those seen in heart disease, kidney disease, and diabetes, can affect the blood vessels in the ears. “It’s a really great area with really fine capillary, and as the diabetes disrupts circulation, it disrupts hearing,” Enock says.
Kathleen Bainbridge, PhD, an epidemiologist at the National Institute on Deafness and Other Communication Disorders, states there are some theories about how diabetes might impact hearing. Bainbridge examined hearing loss in people with diabetes in a 2008 research study published in the Annals of Internal Medicine and discovered that individuals with diabetes are two times as most likely to have hearing impairment as individuals without the disease, and those with prediabetes have a 30 percent greater rate of hearing loss, compared to individuals with normal blood glucose. While the study did not look at what was occurring to the tissue in the inner ear, Bainbridge says that diabetes might be affecting the blood vessels.
“Hearing loss may be another problem of poorly managed diabetes or maybe diabetes of long period of time, similar to diabetic kidney disease or diabetic retinopathy,” she states. “Like the kidneys, the structure of the inner ear is extremely vascularized, so hearing loss might be the result of modifications to the small blood vessels of the inner ear.”
Kathleen Yaremchuk, MD, chair of the Department of Otolaryngology — Head and Neck Surgery at Henry Ford Hospital in Detroit, states that much like the microvascular damage observed in the eyes and kidneys of people with unrestrained diabetes, an action might occur in the ears, too. “The better managed,” she states, “the less most likely you are to suffer the untoward consequences.”
Another theory is that diabetes could cause changes to the sensory nerve cells or fibers of the auditory nerve. The condition is currently known to cause peripheral nerve damage in the feet and hands of individuals with uncontrolled diabetes, states Bainbridge.
Furthermore, due to the fact that noise is an aspect for hearing loss in general, Bainbridge states, “it’s possible that individuals with diabetes are particularly prone to the negative results of sustained loud sound.” However she keeps in mind that none of these theories have actually been definitively explained by existing research.
A 2012 research study from Henry Ford Hospital found that women in between the ages of 60 and 75 with unchecked diabetes had more hearing loss than women because age group with well-controlled diabetes. Researchers also found out that hearing was worse general in women younger than 60 with diabetes — even well-controlled diabetes — than in women without diabetes. Yaremchuk, the principal investigator for the study, states that while it’s difficult to speculate about what is taking place in the ears without a microscopic examination, the research study did show that diabetes is a risk factor for hearing loss.
For the research study, Yaremchuk and her team looked at records for 990 patients who had audiograms, a type of hearing assessment, between 2000 and 2008 at the healthcare facility. Individuals with diabetes were put into two groups: those with well-controlled diabetes and those with unrestrained diabetes, based upon American Diabetes Association A1C targets. After evaluating individuals’ ability to hear at specific frequencies and recognize speech, the researchers discovered that hearing loss was associated especially with older women with uncontrolled diabetes and younger women with diabetes in general.
Men were found to have even worse hearing overall compared with the women in the study, no matter their age or whether they had diabetes. There was also no considerable difference in hearing amongst men with unchecked diabetes, those with well-controlled diabetes, or those who did not have diabetes.
“We know what normal is for different age groups, and those patients with diabetes were found to have actually increased hearing loss that wouldn’t be anticipated for their age,” says Yaremchuk.
Bainbridge agrees that excellent diabetes control is important for overall health, but states that it’s hard to know for sure if this will prevent hearing loss, as it hasn’t been explicitly evaluated.” [Blood glucose management is] continued great practice for people with diabetes, and they might have the advantages of a lower degree of hearing loss,” she states, “however it hasn’t yet been borne out in the research.”
Another research study, published in 2011 in Diabetes Care, looked at risk factors for hearing loss in individuals with diabetes and discovered that low HDL (“good”) cholesterol, coronary artery disease, peripheral neuropathy (nerve damage), and poor health in general increased the risk for hearing loss. Researchers mentioned that those elements are potentially avoidable, nevertheless, and could lower the risk for hearing loss if controlled.
Amongst people with diabetes, those who were older, white, male, or had a lower income had a higher possibility of hearing problems. In addition, they found that blood sugar control, years because medical diagnosis, and type of diabetes medication did not appear associated to hearing loss.
Bainbridge says that while she has actually taken a look at A1C levels in people with diabetes and did not discover a connection with hearing loss, a recent Japanese research study discovered that raised A1C levels were associated with an increased risk for hearing loss in the future. “That’s beginning to show early evidence that [hearing loss] might be related to blood sugar levels,” she says.
While it may be possible to prevent hearing loss by controlling diabetes and other health problems, what about individuals who are already difficult of hearing? For that, Enock states listening devices help.
“The appeal of the digital hearing age is we can now shape the noise,” she states. In the past, all hearing aids were analog and amplified all noises, however digital listening devices are much nimbler. If background noise is too loud, digital hearing aids can filter it out.
Enock says listening devices may be able to help keep the brain linked to the world — and individuals with hearing loss linked to life. It is crucial, says Enock, to make sure that the brain continues to be stimulated by hearing and understanding words. “If we do not get the signal to the brain, the brain loses the capability to understand,” she states. “The ears are just a channel to the brain. The brain is doing all the thinking.” For example, consonants remain in a much greater frequency variety than vowels, and add clarity to speech. So high-pitched hearing loss can make it tough for the brain to understand words and their meaning, she includes.
In reality, hearing loss and dementia may be linked, according to a 2011 study from Johns Hopkins University. Researchers found that individuals with mild hearing loss were two times as likely to develop dementia as those with perfect hearing. The risk of dementia was three times greater in individuals with moderate hearing loss and 5 times greater in those with severe hearing loss.
Enock and Yaremchuk agree that if you notice yourself or a member of the family having difficulty hearing or understanding, it’s important to be evaluated for any problems.
Signs of Hearing Loss
The following habits can show hearing loss, according to Debbie Abel, AuD, a senior specialist at the American Academy of Audiology:
- They frequently ask you to duplicate yourself.
- They appear to have difficulty hearing when there’s background sound, such as at a restaurant.
- They have difficulty hearing on the phone.
- The TV is shown up extremely loud.
- They say they are having difficulty hearing their household.
- They appear to hear some things however not all (selective hearing).
- Words sound dull or uncertain.
- You have problem comprehending discussions.
- Music sounds metallic or tinny.