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Of all the concerns you might have about health conditions related to diabetes, hearing loss is probably not at the top, middle, or maybe even the bottom of your list. But hearing loss is twice as common for the more than 37 million people in the U.S. who have diabetes, according to the American Diabetes Association. Even those 133 million adults in the U.S. with prediabetes have a 30 percent higher rate of hearing loss than those without the condition.
Baffled by what the connection could be? Well, it’s the same issue that causes so many other health issues for those with diabetes: nerve damage (neuropathy).
Scientists believe that high blood sugar causes damage to small blood vessels and nerves in the inner ear, according to the CDC. Low blood sugar can also contribute, doing damage to how nerve signals travel from the inner ear to your brain. Both types of nerve damage, the CDC notes, can lead to hearing loss.
Diabetes can also create dysfunction in the vestibular system. That’s the part of your inner ear that helps with balance. In fact, vestibular dysfunction is 70 percent higher in people with diabetes, compared to those who don’t have it. This can make it difficult for the signals related to hearing and balance to reach the brain.
Here are a few other ways diabetes could impact hearing, according to the CDC:
- Diabetes may cause negative effects on the semicircular canals and otolith organs of the inner ear. These effects contribute to problems with the vestibular system. And, clearly, problems with balance can lead to falls. In fact, the incidence of falls is 39 percent higher.
- Diabetes can reduce what’s called cerebral microcirculation (the main distribution system for oxygen and nutrients fueling brain tissue), including in the auditory centers of the brain, affecting hearing.
- Diabetes may also affect cortical auditory processing, which can impact hearing.
A recent study in India discovered a relationship between age, nephropathy (kidney disease), and neuropathy with hearing loss among patients with diabetes. One of the more significant takeaways was that the severity of hearing loss worsened as the severity of neuropathy and A1C levels increased.
Tinnitus
Related to hearing loss is tinnitus, the condition that causes people to perceive a sound — like ringing, roaring, or buzzing — that doesn’t come from an external source. The National Institute on Deafness and Other Communication Disorders has noted that most people who have tinnitus have some degree of hearing loss. There are numerous causes of tinnitus, including noise exposure, hearing loss, medications, earwax or ear infection, or head or neck injuries. But it can also be caused by chronic conditions, including diabetes.
A 2021 study by Iranian researchers found that type 2 diabetes can be associated with the severity of tinnitus. They identified that the tinnitus-related problems were connected with the duration of diabetes, noting that it was more severe among patients who had diabetes for more than 10 years. Their conclusion was that in patients with diabetes, tinnitus can be an indicator of developing neuropathy.
Many people with diabetes know that they should have their eyes tested annually. You may be unaware, however, that some authorities also recommend annual hearing tests. The CDC, for example, says, “You should have your hearing tested by an audiologist when you first find out you have diabetes and then every year after.”
You may also want to ask your doctor or see an audiologist if you experience the following:
- Hear ringing or other noise in your ears or head.
- Have problems hearing or maintaining your balance.
- Become dizzy, fall, or feel worried you could fall.
- Frequently ask others to repeat themselves.
- Have a sudden change in how clearly you can understand what people are saying, especially conversations with more than two people.
- Have trouble understanding what people are saying because of background noise.
- Have trouble hearing people with high or quiet voices, such as children.
- Feel like people are mumbling when they talk to you.
- Turn up the volume of the TV or radio too loud for others nearby.
An audiologist can test not just your hearing, but also screen you for balance-related problems caused by changes in the vestibular system.
The CDC also recommends that those with diabetes wear ear protection around loud noises, eat a healthy diet, and manage their blood glucose levels. Monitor your hearing by paying attention to changes in it. Ask family and friends if they’ve noticed hearing changes in you. Ask your doctor if any of your medications could damage your hearing and find out if there are other available options.
You can also take a self-assessment tool, like the Hearing Handicap Inventory Screening (PDF). If the results show you may have a hearing problem, discuss this with your doctor and ask for a referral to an audiologist to determine what the issue is and how it can be treated.