Though not as well-known as heart disease, nerve damage, or vision problems, hearing loss is a potential complication of diabetes. Learn how to protect this critical sense.
People with type 2 diabetes are generally aware of potential complications like nerve damage, heart disease, and eye problems. But did you know that type 2 diabetes is also associated with hearing loss?
In fact, people with diabetes have two times the rate of hearing loss as people without the condition, according to the American Diabetes Association (ADA).
The link between hearing loss and diabetes isn’t well understood. One theory: High blood sugar levels cause damage to the small blood vessels in your inner ear, similar to the way they can damage blood vessels in your heart, kidney, and nerves, according to the ADA.
“Diabetes affects the small blood vessels in the ear, just as it affects blood vessels throughout the body,” explains endocrinologist Kashif M. Munir, MD, medical director of The University of Maryland Center for Diabetes and Endocrinology in Baltimore.
There are several reasons why it’s challenging for researchers and physicians to make the correlation between diabetes and hearing loss. One is that people with type 2 diabetes who have obvious hearing loss also tend to be older, which makes it hard to know whether their hearing loss is directly due to diabetes or an age-related condition, according to Dr. Munir.
In addition, hearing loss often occurs gradually, without being noticed at first. When researchers compared the hearing of 108 veterans who have diabetes with 114 veterans of a similar age who did not, they found that those with diabetes had more hearing loss. The hearing measures also suggested that the hearing damage may have begun early in the course of diabetes, the researchers reported in the May and June 2016 issue of Ear and Hearing.
Signs of Hearing Loss
“Your hearing loss tends to be a gradual sort of event,” says audiologist and researcher Christopher Spankovich, AuD, PhD, an associate professor at the University of Mississippi Medical Center in Jackson. Any sudden loss of hearing requires a visit to the emergency room, he says, but hearing loss related to diabetes can be so gradual that you might not even realize that your brain is already trying to compensate for the sounds you aren’t hearing well. Certain consonant sounds might be the first that you lose, for example, and your brain simply adapts.
According to the ADA and the American Academy of Audiology, signs of hearing loss include:
- Frequently thinking other people are mumbling
- Often asking people to repeat what they’ve said
- Turning up the volume past the level comfortable for others around you
- Difficulty following a conversation
- Difficulty hearing others in a loud environment, such as a restaurant
- Difficulty hearing people who are not facing you
- Frequently hearing buzzing, ringing, or rushing sounds in your ears
If you’re experiencing any of these signs, schedule a hearing screening test with an audiologist.
Protect Your Hearing
Your diabetes management can depend on understanding your medical team’s instructions, so it’s essential to address any hearing problems head on. “Patients with hearing loss may need more visual cues, written communication, and for us to ask them to confirm that they understand what we have said,” Munir says. If you need any of these strategies to understand what your doctor is saying, ask for them.
The following tips can help you protect your hearing and manage your diabetes:
- Control your blood sugar. “Try to do your best in terms of keeping blood sugars under control,” Munir says. Diet, exercise, medications, and testing your blood sugar all can help you achieve your goals for control, which in turn lessens the risk of all complications, including hearing loss.
- Eat a healthy diet. A healthy varied diet, with limited fat and salt, may protect against hearing loss even when you are exposed to loud noise frequently, according to the results of data that Spankovich and colleagues analyzed from the National Health and Nutrition Examination Survey 1999-2002. The conclusions were published in the November 2014 issue of the International Journal of Audiology.
- Protect against noise. Wear ear plugs or ear coverings to reduce noise exposure if you are in a place where noise is at or above 85 decibels. This is about the level of noise made by a blow dryer or kitchen blender, according to the American Speech-Language-Hearing Association (ASHA). If you find yourself in a noisy environment without these, it may be best to leave.
- Turn down the volume. Keep the sound of radios, TVs, tablets, and phones at less than half the volume, especially if you are using headphones or earbuds. Signs that the volume is too high: you have to raise your voice to be heard, you can’t hear someone three feet away from you, or you have the sensation of ringing in your ears or muffled hearing, according to ASHA.
- Avoid medications that harm your hearing. “Ototoxic” medications can affect your hearing and balance, according to ASHA. There are more than 200 medications with either permanent or temporary ototoxic effects. Ask your doctor or pharmacist about the medications you take.
- Don’t put things in your ears. Clean the outside of your ear gently, but don’t put a cotton swab or anything else into your ear canal.
- Get your hearing checked. While there are no official recommendations for hearing screenings when you have diabetes, Spankovich recommends one if you have any concerns.