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Diabetes and Hearing Loss

During the last 6 years practicing audiology in the Lowcountry, I have made it a routine part of my case history to ask my patients if they have diabetes. You might wonder why I need to know if you have diabetes. After all, what does diabetes have to do with the ears?

Diabetes mellitus II has been found to be a strongly associated factor in hearing health. Some of the known associations between diabetes and hearing loss include:
- Vascular problems that lead to damage of the blood vessels and hair cells in the hearing organ, causing permanent hearing loss.
- Tendency for abnormal pH balance in the external ear, which leads to a tendency to build up more ear wax.
- Breakdown of skin tissue in the ear canal, or extra-sensitive tissue in the ear canal.
- The ear canal tends to experience chronic irritation, fungus, yeast, and, in stubborn cases, infection (otitis externa).
- Higher-than-usual incidence of recruitment, where there is an over-sensitivity to loud sounds
- Vestibular and balance problems (dizziness, vertigo).
- Nerve cell damage in the may result in slower processing of complex sounds such as speech, even if little or no hearing loss exists.

Diabetes mellitus II, otherwise known as Type II diabetes, is the most common type, occurring in about 90-95% of people diagnosed. Type II is the non-insulin dependent type of diabetes. Type II primarily affects adults, especially those over 40 years of age. More women than men experience this type of diabetes, and it tends to run in families. In these cases, the pancreas produces insulin, but not the type, pH, or quality needed by the body.

The past 20 years have shown a significant increase in the number of people diagnosed each year with diabetes. Recognized cases of diabetes (those reported to the Center for Disease Control) in the US number approximately 11 million, with another 6-8 million undiagnosed cases, making an estimated total of more than 17 million cases. This figure does not account for another 16 million pre-diabetic cases, such as hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). When these populations are combined, an estimated 33 million potential diabetes-related patients emerge, representing more than 10% of the U.S. population. Hearing loss is also estimated to affect this same number of people, closer to the 28 million mark.

We are still not able to say that having a specific type or degree of diabetes will absolutely cause a specific type and degree of hearing loss. However, we do know that diabetes can have negative effects on the health of the ears and hearing. I recommend annual hearing evaluations for all Type II diabetics, particularly if you have concerns about your ears, your balance, or your hearing.

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