Can Diabetes Cause Hearing Loss?

All forms of diabetes, including type 1 and type 2 diabetes, are defined by high blood sugar levels. This excess sugar can do damage to many parts of the body — including the parts of the ear that are needed for hearing.

Rahul Mittal, PhD, a professor and ear, nose, and throat specialist with the University of Miami School of Medicine, says that chronic high blood sugar levels can damage the blood vessels and nerves in the inner ear, which are crucial for auditory function. This condition, known as microangiopathy, reduces blood flow and impairs the delivery of oxygen and nutrients to the delicate structures of the ear.

Essentially, high blood sugar levels appear to damage both the nerves that are used for hearing and the blood vessels that supply the nerves with what they need to function. Other types of metabolic dysfunction may also play a role. “Additionally, oxidative stress and inflammation caused by diabetes can lead to further damage to the sensory cells and neural pathways involved in hearing,” Dr. Mittal says.

This is the most common form of hearing loss, the variant that so often causes the declining hearing of older adults. SNHL can affect one ear or both ears, in which case it may be stronger in one ear than the other. Sounds may be muffled, and it may become more difficult to perceive high voices or to navigate noisy environments or conversations with multiple people. “Hearing loss in diabetes often presents as high-frequency sensorineural hearing loss, which can develop gradually and remain unnoticed until it becomes more pronounced,” says Mittal.

Of course, people with diabetes can experience any other type of hearing loss, too. Conductive hearing loss occurs when sounds are blocked or muffled in the middle or outer ear. This is often due to physical factors such as ear wax, fluids, foreign objects, or bone abnormalities. Diabetes does not increase the risk of conductive hearing loss.

• Age Advanced age can increase the risk of hearing loss. Hearing loss is particularly common in adults over the age of 70.
• Hypertension High blood pressure, which is common in people with diabetes, is also a significant contributor to hearing loss.

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• Obesity Being overweight or having obesity can also increase hearing loss risk.

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   Obesity is particularly common among people with type 2 diabetes.

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For people with diabetes, hearing loss prevention may start with blood sugar management. “People with diabetes should focus on maintaining good glycemic control to minimize the impact of high blood sugar on the auditory system,” Mittal says. That means using diet, exercise, and medication to keep your blood sugar in the range recommended by your healthcare providers. The same healthy habits that maintain or lower your blood pressure and bring cholesterol levels to a good range may also prevent hearing loss.

“Managing other risk factors such as hypertension and dyslipidemia through lifestyle changes and medications can also be protective. Regular physical activity and a balanced diet rich in antioxidants may help reduce oxidative stress and inflammation, both of which are implicated in hearing loss,” Mittal says.

“People with diabetes should consider undergoing hearing screening every three to six months, depending on their age, overall health, and history of glycemic control. Regular screenings are particularly important for individuals experiencing other diabetes-related complications, as they may be at a higher risk for hearing loss.”

People with diabetes can also be on the lookout for early warning signs that can indicate hearing loss.

“Key signs to watch for include: difficulty understanding speech, especially in noisy environments; frequently asking others to repeat themselves; the perception that others are mumbling; and the need to increase the volume on televisions or phones. Tinnitus, or ringing in the ears, may also be an early sign of auditory damage in individuals with diabetes,” says Mittal.

People with diabetes who experience hearing loss can benefit from the same treatments as other people without diabetes. Though hearing loss usually can’t be reversed, medical devices can make it easier to hear, and lifestyle and communication adjustments can help you understand the world around you.

• Hearing aids amplify some sounds for people with sensorineural hearing loss.

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• Cochlear implants pick up sounds in the environment and send signals to the auditory nerve, essentially getting around the damaged part of the auditory pathway.

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The Takeaway

• People with diabetes may be twice as likely to experience hearing loss.
• Hearing loss can be a direct consequence of high blood sugars, and is often related to additional risk factors like high blood pressure and obesity.
• Annual screening, avoiding loud environments, and other forms of hearing protection can minimize hearing loss risk for people with diabetes.