Audiologist, Sakhile Nkosi, unpacks whether there is a link between diabetes and hearing loss.
Every person living with diabetes worldwide knows upon diagnosis that there are different types of diabetes e.g. Type 1 and Type 2 diabetes. Your doctor likely provided rigorous counselling, explaining all the clinical manifestation present in diabetes, such as loss of sensation in the feet (neuropathy), vision disturbances, kidney problems, etc. and the importance of taking medication and maintaining a healthy lifestyle to prevent these complications.
Most research conducted, so far, gave concrete evidence on what can possibly go wrong with an individual living with diabetes. Though, one of the unfamiliar complications that the diabetic community isn’t often made aware of, is the effect of diabetes on the ear structure. Hence, hearing and balance.
The ear is one of the most important organs in the human body. It provides two basic functions: hearing and to balance. Hearing itself is a special sense, just like vision; it forms basis of communication.
Hearing loss occurs as a result of damage either in the outer, middle or inner (retro-cochlear) part of the ear. If hearing loss is left untreated, it can have negative consequences on an individual’s life. This includes physical, emotional and social health and can cause disturbing effects in relationships with colleagues, family and friends. In children, hearing loss can cause a delay in speech and language development.
The link between diabetes and hearing loss and balance
Current research reveals the link between diabetes and hearing loss. As early as 2008, the National Health and Nutrition Examination Survey results found that individuals with diabetes are at risk of developing hearing loss compared to those without diabetes.
The results of the survey revealed that individuals with diabetes are prone to a degree of hearing loss ranging from mild to moderate. The type of hearing loss common in diabetic patients is sensorineural in nature, implying the hearing loss is caused by damage to the inner ear or the hearing nerve that carries sound to the brain.
In terms of balance, patients who are diagnosed with diabetes may be at a higher risk for falls. This happens because of how diabetes affects the normal function of vision, sensation in feet, ankles, knees, hips, and inner ears.
As you may be aware, diabetes can affect the normal function of the retina of the eye. If the retina is damaged by diabetes and vision is distorted, the brain is deprived of information and needs help to maintain your balance.
Diabetes also can affect whether you have sensation in your feet. If your feet are numb (due to diabetes), you’ll not be able to sense when you are leaning forward, backward or side to side. In darkness, this becomes a larger problem because you lose the help that you normally would get with vision. This becomes a larger problem, a fall risk, if you also lose function in the inner ears.
Signs and symptoms of hearing loss
One might experience a few or a combination of symptoms.
- Speech and other sounds are perceived muffled.
- Difficulty understanding words or speech in a presence of background noise or crowd.
- Frequently asking other to speak more slowly, clearly and loudly.
- Constantly turning the TV/radio volume up.
- Often withdrawing from conversations.
- Avoiding certain social settings.
How to protect your hearing and balance?
You might have not yet experienced symptoms related to hearing and balance, but prevention is better than cure. Take charge of your diabetes by:
- Controlling your blood sugar by taking your prescribed medication.
- Noise can damage your hearing. At home, wear ear plugs when you are running the lawn mower or any other loud appliance. Take ear plugs with you when you attend concerts and sporting events that may be too loud.
- Have your hearing tested by an audiologist on a regular basis. At least annually or sooner if you notice changes.
- If you have a hearing impairment, your audiologist might fit you with hearing devices that will improve your ability to converse with others (e.g. hearing aids and assistive hearing devices).
- Reduce background noise when you have a conversation (radio, TV, etc.)
- Your doctor may recommend that your inner ears be evaluated by an audiologist to diagnose why you are dizzy and whether it is vertigo. Referrals will be made to other professionals, such as physiotherapists and occupational therapist.
- Work with your doctor to determine whether changes in your medications might explain changes in your balance.
The Audiology Project https://www.theaudiologyproject.com/
Bainbridge, K., Hoffman, H., & Cowie, C. (2008). Diabetes and Hearing Impairment in the United States: Audiometric Evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med
Akinpelu, O., Mujica-Mota, M., & Daniel, S. (2014). Is type 2 diabetes mellitus associated with alterations in hearing? A systematic review and meta-analysis. Laryngoscope, 767-76.
Arlinger, S. (2003). Negative consequences of uncorrected hearing loss – A review. International Journal of Audiology, 42(2), S17–2 S20.
Hlayisi, V., Petersen, L., & Ramma, L. (2018). High prevelance of disabling hearing loss in young to middle-aged adults with diabetes. Int J Diabetes Dev Ctries, 39(1), 148-153. doi:10.1007/s13410-018-0655-9.
MEET OUR EXPERT
Sakhile Nkosi is an audiologist in the public sector. He has been exposed to lots of conditions that are in line with the global burden of diseases, one of them is diabetes. Currently, Sakhile holds a portfolio as a public sector representative at the South African Association of Audiologists (SAAA) and is also part of The Audiology Project (TAP), South African Cohort.