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What is the diabetes-related hearing loss (DRHL)?

When you come to my clinic for a hearing test I'll ask you several questions, including any health issues you may already have. Diabetes, gout, vascular disorders and a few other health problems can directly impact your hearing loss regardless of your age.


This article elaborates a bit on the impact of diabetes on your hearing loss.


Nearly half (45%) of all adults with diabetes (type 1 and type 2) suffer from diabetes-related sensorineural hearing loss (DRHL), which is over twice as high as adults with age-related hearing loss (ARHL). Diabetes tends to cause hearing loss to progressively worsen over time and causes a greater degree of hearing loss compared to non-diabetic people.


Younger diabetic people (21-64 years) tend to have 20 dB worse hearing loss in high frequencies (>12 kHz) than non-diabetic people with ARHL, and older diabetics (59-92 years) with DRHL tend to have worse hearing (12 dB) in the low frequencies (1-4 kHz) than those with ARHL.


Duration of diabetes mellitus (DM) is directly related to severity. Those with diabetes for 1-3 years tend to have mild hearing loss, and with longer duration (4-12 years) the hearing loss becomes more severe.


Glycosylated haemoglobin (HbA1c) is a major factor in hearing health. Diabetic patients who have insufficient glycemic control (HbA1c ≥ 8%) experience a higher prevalence of hearing loss (62%) compared to those with good glycemic control (HbA1c < 8%) (48%). High HbA1c (6.1%) corresponded to an increased risk of hearing loss and 3-6 dB worse hearing thresholds than those with lower HbA1c (5.3%).



DRHL or diabetes related hearing loss explained.

Figure 1. Inner ear structure


Figure 1 depicts the physiological structure of the inner ear up to the auditory central system. Panel (B) shows typical pathological changes of the spiral modiolar artery (SMA) damage where the vessel wall thickness is significantly greater in diabetic people.  Panel (C) depicts typical pathological changes of the stria vascularis (SV) and vessels of the stria vascularis (VSV) where significant thickening and complete occlusion or disappearance of the lumen may occur. Panel (D) shows typical pathological changes of the spiral ganglion damaged by DM. Panel (E) shows a cross-section showing typical pathological changes of cochlear afferent nerve fibres damaged by DM. Panel (F) depicts typical pathological changes of the organ of Corti (OC) where there was a further reduction in the number of outer hair cells (OHCs), but not in the inner hair cells (IHCs).



That's why as your audiologist I ask you if you have diabetes. Diabetes causes a greater prevalence of hearing loss and progressively worsening hearing loss over time.


If you have diabetes and feel that your hearing is not as sharp as before you better do a quick hearing test.





References

Deng et al (2023). Diabetes mellitus and hearing loss. Molecular Medicine, 29:141



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