Hearing Loss and Diabetes: You Might Not Know What You're Missing

Diabetes is a complex multisystem disease that requires routine monitoring for known complications affecting the renal, visual, and peripheral nervous systems. Research has hinted at an increased risk for hearing loss in diabetic patients, but confounders of noise exposure, ototoxic drug exposure, presbycusis, and known syndromes that affect both glucose metabolism and cochlear function make it difficult to establish this association (1–5). Currently, there are no formal recommendations for screening for hearing loss in diabetic patients (6).

The article by Bainbridge and colleagues (7) in this issue reports on the risk for hearing loss in persons with self-reported diabetes. In a cross-sectional study, they used the National Health and Nutrition Examination Survey to determine the relative risk for sensorineural hearing loss in a community-based random sample of patients who reported a history of diabetes. They found that persons with diabetes were at increased risk for hearing loss (adjusted odds ratio, 2.2 to 2.4). The degree of hearing loss ranged from mild to moderate, causing deficits that would be difficult to detect without screening but would pose substantial impairment for communicating.

One previous study (2) provided evidence that diabetes affects hearing. Cullen and Cinnamond (2), who used a large population-based data set, reported an odds ratio for hearing loss of 1.41 in non–insulin-dependent diabetic patients. A possible explanation for the divergent results between this study and Bainbridge and colleagues' (7) is that …