Diabetes Mellitus and Hearing Loss

Diabetes mellitus increases the risk of developing hearing loss. Acquired bilateral hearing loss is associated with dementia, decreased cognitive function, social isolation, and depression in the elderly. Screening for hearing loss among individuals affected with diabetes mellitus can help the physician identify the affected individuals and facilitate early hearing rehabilitation thereby reducing the morbidity associated with it. Microangiopathy, diabetic neuropathy, and mitochondrial damage are the mechanisms by which diabetes mellitus causes hearing loss. Increasing age, elevated HbA1c levels, reducing eGFR, and worsening diabetic neuropathy are factors that increase the risk of developing hearing loss in individuals affected by diabetes mellitus. Apart from the direct effect of the disease process, antidiabetic drugs such as biguanides, synthetic insulin, glucagon-like peptide -1 receptor agonists, and dipeptidyl-4 inhibitors can cause hearing impairment. Drugs used to treat co-morbid conditions such as aspirin can also exert its ototoxic effect affecting hearing acuity. Screening tools such as single-question screening and hearing handicap inventory for the elderly screening version (HHIE-S) are effective in identifying diabetics with heating loss.