The Link Between Diabetes and Hearing Loss

The prevalence of diabetes is increasing worldwide. Globally, adult diabetes has nearly doubled and is rising more rapidly in middle and low-income countries.


According to the World Health Organisation, in 1980, 108 million people were diagnosed with diabetes worldwide. By 2014, the figure was 422 million. In South Africa, 7% of adults have diabetes - that is 3.85 million people. In the United States, the numbers are higher with more than 30 million american diabetes patients.

Diabetes leads to high blood sugar levels. If left untreated, diabetes can cause blindness, kidney failure, heart attack, stroke and lower limb amputation.

But, did you know that diabetes can also cause patients to have trouble hearing?

 

How Does Diabetes Affect Hearing Loss

The inner ear is delicate and we depend on it everyday to communicate, learn and socialize.

Inner ear hair cells which are responsible for converting sound vibrations into electrical impulses and sending them to the brain to interpret them, rely on good circulation to maintain a healthy status.

In humans and all mammals, sensory hair cells DO NOT regenerate! Once hair cells are damaged, hearing is permanently affected.

Uncontrolled diabetes can take a toll on small blood vessels throughout the body. This in turn damages the hair cells in your ears. The result is that in symptoms of hearing loss are common in those with diabetes.

Various studies have compared the hearing levels of adults with diabetes to those without and have found that diabetes patients presented with poorer thresholds across frequencies. This was more pronounced in the higher frequencies.

Additional published studies show increased hearing loss among those diagnosed with diabetes who also smoke.

Multiple studies show compelling results indicating that the hearing tests of those with diabetes had higher thresholds at ultra-high frequencies (9000-16000 Hz) than individuals without the disease. This suggests that testing conventional and ultra-high frequency throughout the frequency spectrum in these individuals is crucial.

Hearing loss in adults often contributes to social isolation, cognitive loss and depression.

 

Annual Audiological Evaluations For Diabetic Patients

Audiologists, clinicians, audiometrists or appropriately trained technicians should obtain baseline hearing evaluations of patients with diabetes as early as possible.

Once a baseline has been obtained, hearing should be monitored annually (across all frequencies, 125 - 8000 Hz).

Ideally, extended high frequencies (8000 - 16000 Hz) should be monitored to help detect any deterioration early on.

 

Benefits of annual hearing tests for Diabetic patients

  1. Early Detection of Hearing loss
    If detected early it is possible to motivate the modification of medical treatment (Research suggests a dose-response relationship between diabetes and hearing loss - in essence, having higher glucose in your blood presents a greater risk of hearing loss).
  2. Early identification and treatment enables the mitigation of the negative effects on patients who experience hearing loss. These Include social isolation, cognitive decline and depression.
  3. Annual hearing tests enable clinicians to educate patients on the risks of diabetic related hearing loss. If patients are aware of the risks they will be more attuned to possible loss and therefore more likely to seek treatment early on and before they need a hearing aid.

Everything a patient does to manage diabetes related complications can reduce the risk of further hearing loss.

 

Why are hearing tests not standard practice for those living with diabetes?

In many parts of the world there is a shortage of both clinicians and equipment available to perform hearing tests. This is especially true in developing countries where vast distances and lack of funding add to the difficulties of accessing hearing care.

Traditional audiology services require the use of a soundbooth to ensure that surrounding noise does not affect the hearing test results. These sound booths are expensive, difficult to move around and are often pose the risk of cross contamination from other infectious diseases.

Added to this is the fact that there has been very little in the form of public awareness of the effects of diabetes on hearing. While much has been done to improve the treatment of diabetes, very little has been done to ensure that the side effects of the disease are appropriately treated or mitigated in terms of loss of hearing.

The result is patients simply do not have access to treatment, unless they are to travel vast distances to receive care.

Doctors, where they are available, refer to audiologists or ENT surgeons (who are also in short supply) for further evaluation. This results in multiple referrals, additional burden on the health system and increased costs for patients who are already suffering from this disease.

 

This is part of the reason we created the KUDUwave.

KUDUwave audiometers combine the soundbooth, headset and audiometer in a single lightweight device that eliminates the need for a soundbooth. This reduces the cost of equipment while enabling truly mobile audiometric services and enables clinicians to reach patients where they are.

Additional technology, in the form of automated testing software, enables technicians, doctors and clinic staff to perform hearing evaluations with minimal training.

The KUDUwave enables medical professionals to access affordable testing equipment without compromising on quality of care. They can now diagnose hearing loss early on which could make the practice of annual hearing tests common in people with diabetes.

Improving access to hearing testing while reducing the cost of equipment required we reduce the extended costs to patients. This means hearing testing can become more commonplace and provide an opportunity to patients mitigate the effects of hearing loss early on.

The KUDUwave combines both conventional and ultra high frequency audiometry in one device (plus the ability to attenuate ambient noise as well as a sound booth). Additionally, it is tele-audiology enabled, allowing one to provide services to multiple sites where hearing healthcare professionals may not be available.

 

 

Topics: Audiometry, Hearing loss, Tele-health, Healthcare

 

Written by
Hlolo Ramatsoma
Hlolo Ramatsoma

Hlolo is a clinical, research & support Audiologist at eMoyo. He is involved in many parts of the business, from consulting to R&D to supporting and training customers. He earned his BSc in Audiology from the University of Cape Town and is an experienced clinical audiologist specialized in ototoxicity monitoring, product specialist and training audiologist.

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