Hearing Status in Patients with Type 2 Diabetes Mellitus According to Blood-Sugar Control: A Comparative Study

Document Type : Original


1 Rhino-sinus, Ear and Skull base Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran .

2 Department of Endocrinology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

3 Department of Otolaryngology, Head and Neck Surgery and Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.


It seems that diabetes mellitus (DM) can affect the auditory system due to neuropathy, micro-vascular complications, and hearing cell damage during hyperglycemic states. In the current study, we aimed to compare hearing status in patients with type 2 DM (T2DM) according to their blood-sugar control status.
Materials and Methods:
This cross-sectional study was carried out in 104 patients with T2DM attending the diabetic clinics of Guilan University of Medical Sciences within a period of 1 year (2014–2015). One group consisted of 52 patients with poor control and the other consisted of patients with moderate-to-good control (according to glycated hemoglobin [HbA1c] level). All subjects underwent pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAEs) assessments. A hearing threshold higher than 20 dB and a signal-to-noise ratio ≤3 in each frequency were considered abnormal.
In PTA, poorly controlled patients showed more frequent hearing loss compared with the well-controlled group, especially at higher frequencies (8 kHz: 67.3% vs 46.2% [P=0.029]; 10 kHz: 46.2% vs 21.2% [P=0.025]). Also, patients in the poorly controlled group had worse cochlear function according to the DPOAE test (4 kHz: 32.7% vs 17.3% [P= 0.002] and 8 kHz: 70.6% vs 40.4% [P=0.006]).
DM and poor control status of diabetes can affect hearing sensation and cause hearing loss, especially at high frequencies. According to our findings, it seems that diabetic patients with a duration of diabetes >10 years, diabetic complications, poor control status or comorbidities should undergo both endocrine and audiologic follow-up to prevent greater sensory neural hearing loss.


Main Subjects

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care. 2004;27:1047–53.
2. Mozaffari M, Tajik A, Ariaei N, Ali-Ehyaii F, Behnam H. Diabetes mellitus and sensorineural hearing loss among non-elderly people. Eastern Mediterr Health J 2010; 16:947–52.
3. World Health Organization – Diabetes country profiles, 2016. Available from: http://www. who.int/diabetes/country-profiles/irn_en.pdf?ua=1.
4. Ferreira JC, Guimarães R, Becker H, Silva C, Gonçalves T, Crosara P. Avaliação metabólica do paciente com labirintopatia. Arq Otorrinolaringol. 2000;4:28–32.
5. Marchiori LLdM, Gibrin PCD. Diabetes mellitus: prevalência de alterações auditivas. Arquivos Brasileiros de Endocrinologia & Metabologia. 2003; 47:82–6.
6. Malucelli DA, Malucelli FJ, Fonseca VR, Zeigeboim B, Ribas A, Trotta F, et al. Hearing loss prevalence in patients with diabetes mellitus type 1. Braz J Otorhinolaryngol. 2012; 78:105–15.
7.  Frisina ST, Mapes F, Kim S, Frisina DR, Frisina RD. Characterization of hearing loss in aged type II diabetics. Hearing Res. 2006;211:103–13.
8. Parving A, Elberling C, Balle V, Parbo J, Dejgaard A, Parving HH. Hearing disorders in patients with insulin-dependent diabetes mellitus. Audiology. 1990;29:113–21.
9. Virtaniemi J, Laakso M, Nuutinen J, Karjalainen S, Vartiainen E. Hearing thresholds in insulin-dependent diabetic patients. J Laryngol Otol. 1994; 108:837–41.
10. Gibbin KP, Davis CG. A hearing survey in diabetes mellitus. Clinical Otolaryngol Allied Sci. 1981; 6:345–50.
11. Harner SG. Hearing in adult-onset diabetes mellitus. Otolaryngol Head Neck Surg 1981; 89: 322–7.
12. Miller JJ, Beck L, Davis A, Jones DE, Thomas AB. Hearing loss in patients with diabetic retinopathy. Am J Otolaryngol 1983;4:342–6.
13. Virtaniemi J, Laakso M, Nuutinen J, Karjalainen S, Vartiainen E. Hearing thresholds in insulin-dependent diabetic patients. J Laryngol Otol 1994;108:837–41.
14. Axelsson A, Fagerberg SE. Auditory Function in Diabetics. Acta Otolaryngol 1968; 66:49–64.
15. Salvinelli F, Miele A, Casale M, Greco F, D'Ascanio L, Firrisi L. Hearing Thresholds in Patients With Diabetes. Int J Otorhinolaryngol. 2004;3(1).
16. Çayönü M, Çapraz M, Acar A, Altundağ A, Murat S. Hearing Loss Related with Type 2 Diabetes in an Elderly Population. J Int Adv Otolo. 2014;10:72–5.
17. Axelsson A, Sigroth K, Vertes D. Hearing in diabetics. Acta Otolaryngol Supplement. 1978; 356: 1–23.
18. Cullen JR, Cinnamond MJ. Hearing loss in diabetics. J Laryngol Otol. 1993;107:179–82.
19. Rajendran S, Anandhalakshmi, Mythili B, Viswanatha R. Evaluation of the incidence of sensorineural hearing loss in patients with type 2 diabetes mellitus. Int J Biol Med Res.2011;2:982-7.
20. Lisowska G, Namyslowski G, Morawski K, Strojek K. Cochlear dysfunction and diabetic microangiopathy. Scand Audiol Suppl. 2001; 52: 199–203.
21. Park MS, Park SW, Choi JH. Distortion product otoacoustic emissions in diabetics with normal hearing. Scand Audiol Suppl. 2001;52: 148–51.
22. Bayýndýr T, Erdem T, Uzer E, Toplu k, Sarý R, zturan O. Evaluation of the Auditory Effects in Controlled and Uncontrolled Type 2 Diabetes Mellitus Using Otoacoustic Emissions. J Turgut Ozal Med Cent. 2010;17:337–41.
23. Ferreira JM, Câmara MFeS, Almeida PCd, Brandão Neto J, Silva CABd. Características audiológicas de pacientes com diabetes mellitus Tipo 2. Revista CEFAC. 2016;18:1050–9.
24. Joshi KD, Galagali JR, Kanzhuly MK, Singh ID. A comparative study on effects of diabetes on auditory functions as measured by BERA and DPOAE. Int J Otorhinolaryngol Head Neck Surg. 2017;3:347–53.
25. Panchu P. Auditory acuity in type 2 diabetes mellitus. Int J Diabetes Develop Countr. 2008; 28:114–20.
26. Gibrin PC, Melo JJ, Marchiori LL. Prevalence of tinnitus complaints and probable association with hearing loss, diabetes mellitus and hypertension in elderly. CoDAS. 2013;25:176–80.
27. Doroszewska G, Kazmierczak H. Hyperinsulinemia in vertigo, tinnitus and hearing loss]. Otolaryngologia Polska. 2002;56:57–62.
28. Orts Alborch M, Morant Ventura A, Garcia Callejo J, Perez del Valle B, Lorente R, Marco Algarra J. The study of otoacoustic emissions in diabetes mellitus. Acta Otorrinolaringologica Espanola. 1998;49:25–8.
29. Angeli RD, Lavinsky L, Dolganov A. Alterations in cochlear function during induced acute hyperinsulinemia in an animal model. Braz J Otorhinolaryngol. 2009;75:760–4.
30. Maia FC, Lavinsky L, Mollerke RO, Duarte ME, Pereira DP, Maia JE. Distortion product otoacoustic emissions in sheep before and after hyperinsulinemia induction. Braz J Otorhinolaryngol. 2008;74:181–7.
31. Safavi Naini A, Fathololoomi MR, Safavi Naini A. Effect of Diabetes Mellitus on the Hearing Ability of Diabetic Patients. Tanaffos. 2003;2:   51–8.
32. Swaminathan A, Sambandam R, Bhaskaran M. Evaluation of the auditory effects of hyperlipidaemia and diabetes mellitus by using audiometry. J Clin Diagnost Res. 2011;5:1528–32.
33. Fukushima H, Cureoglu S, Schachern PA, Kusunoki T, Oktay MF, Fukushima N, et al. Cochlear changes in patients with type 1 diabetes mellitus. Otolaryngol Head Neck Surg 2005; 133: 100–6.