Diabetes is a chronic condition that affects a person’s blood glucose levels. While the exact cause is still unclear, people living with diabetes may be at a higher risk of hearing loss. This might be due to high sugar levels potentially causing nerve damage to the inner ear.

Diabetes is a condition that affects blood sugar regulation in the body. This can cause fluctuations in blood glucose, known as hypo- and hyperglycemic episodes.

If a person is unable to maintain their blood sugar levels within a healthy range, this may increase their risk of complications, which could include hearing loss.

The exact relationship between diabetes and hearing loss still remains unclear. However, health experts believe that chronic hyperglycemia, which can raise blood pressure and cause damage to several parts of the body, may damage the blood vessels and inner ear structures, which could lead to hearing loss.

In this article, we look at the link between diabetes and hearing loss and suggest steps people with diabetes can take to protect their hearing.

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Evidence suggests that individuals with diabetes are twice as likely to have hearing loss as those without diabetes. According to the Centers for Disease Control and Prevention (CDC), uncontrolled high blood sugar levels may lead to hearing loss.

This is because chronic high blood sugar levels may damage the nerves and small blood vessels in the inner ear. Over time, low blood sugar levels may also affect how nerve signals travel from the inner ear to the brain.

The CDC also states that prediabetes can be a risk for hearing loss. People whose blood sugar levels are elevated may be at a 30% higher risk of hearing loss than those with healthy blood sugar levels.

Health experts do not know the exact cause of hearing loss in individuals with diabetes. However, research suggests that sustained high blood sugar levels could lead to damage in the inner ear.

High blood sugar levels may affect blood supply to the small blood vessels and nerves in the inner ear, resulting in damage and affecting hearing. Nerve damage can occur in both type 1 and type 2 diabetes.

Blood sugar levels outside a healthy range may also affect how nerve signals travel to the brain from the inner ear. This damage can also lead to hearing loss.

Other risk factors for hearing loss may include:

  • aging
  • frequent or prolonged exposure to loud noise
  • genetics
  • certain conditions, such as measles, mumps, meningitis, multiple sclerosis, and stroke
  • certain medications, including anti-inflammatory drugs, antibiotics, and diuretics, as they can cause permanent ear damage
  • trauma to the ear through head injuries
  • certain chemicals, as they can cause damage to the ears

To diagnose hearing loss, a doctor, such as an audiologist, may take a person’s medical history and assess any symptoms.

Possible symptoms of hearing loss can include:

  • frequently asking people to repeat what they have said
  • having difficulty following a conversation involving more than one other person
  • thinking that other people are mumbling
  • having difficulty hearing people in noisy places, such as a busy restaurant
  • experiencing difficulty hearing people who speak quietly
  • needing to have the TV or radio turned on loudly, which others nearby may find too loud
  • having difficulty hearing everyday sounds, such as a telephone, a doorbell, or an alarm clock

A doctor may then carry out a hearing exam. This may include a number of different hearing tests, such as:

  • Pure tone testing: A person will wear headphones, and a number of beeping sounds will play. The sounds travel through the outer and middle ear and help identify the quietest sounds the person can hear. The person will indicate to the doctor when they hear a beep.
  • Speech testing: A doctor will say various words to a person through headphones, and the person will need to repeat the word they heard. This can indicate the quietest level of sound at which the individual can hear uttered words.
  • Middle ear tests: A doctor may insert a small probe into the ear to check how the eardrum is moving, whether it has a tear, and whether there is any fluid buildup behind the eardrum. These tests may help rule out any other causes of hearing loss.
  • Auditory brainstem response (ABR): An ABR test can show how the pathways between the inner ear and the brain are working. A doctor will place electrodes on a person’s head that attach to a computer. This will allow them to see brain wave activity as the person hears sounds through headphones.
  • Otoacoustic emissions (OAEs): An OAE test shows how well the inner ear responds to sound. This test uses a small probe to measure vibrations from hair cells in the inner ear in response to sound.

A doctor may also test blood glucose levels. An A1C test is a useful tool to help monitor diabetes, as it measures the body’s average blood sugar levels over the past 3 months.

The aim of treatment is to improve people’s hearing and their ability to communicate with others.

The type of hearing loss usually associated with diabetes is sensorineural hearing loss (SNHL). This is a type of hearing loss that occurs due to damage to the inner ear or the nerves between the inner ear and the brain.

Treatment for SNHL may include:

  • Digital hearing aids: A digital hearing aid is an electronic device that fits into the ear and increases the volume of any sounds entering the ear.
  • Cochlear implants: A cochlear implant is a hearing device that sits under the skin in the inner ear.
  • Auditory brainstem implants: This is a device that may be suitable if the hearing nerve is not functioning as effectively and is causing severe hearing loss. A doctor implants this device through surgery.
  • Lip reading or sign language: If people have severe hearing loss, they may consider using sign language or lip reading to help communicate with others.

If hearing loss is due to nerve damage from diabetes, treatment will also involve close monitoring of blood sugar levels. This may also include lifestyle changes, such as following a balanced diet and getting regular exercise.

While managing blood sugar may help stop progression, it will not reverse existing damage to hearing.

Keeping blood sugar levels within healthy ranges may help protect hearing and prevent damage to the inner ear and hearing nerves.

The National Institute of Diabetes and Digestive and Kidney Diseases offers the following suggestions to help people with diabetes control their blood sugar levels:

  • Regularly monitor blood glucose levels.
  • Follow a diabetes meal plan after discussing it with a doctor. The meal plan may include a range of fruits, vegetables, lean protein, whole grains, fish, and legumes.
  • Drink plenty of water and avoid beverages containing sugar.
  • Limit intake of foods high in calories, saturated fats, trans fats, added sugars, and salt.
  • Exercise regularly, aiming for at least 30 minutes of physical activity per day.
  • Reach or maintain a moderate body weight.
  • Quit smoking, if applicable.
  • Take any medication for diabetes as prescribed.
  • Learn how to measure and control blood pressure and cholesterol levels.

Learn more about managing diabetes here.

It is also important that individuals with diabetes attend a hearing test when they first receive a diabetes diagnosis. It is then advisable that they regularly test their hearing every year.

People can also take other steps to protect their hearing, such as using earplugs or ear defenders around loud noise.

Health experts do not know the exact cause, but evidence points to a relationship between diabetes and hearing loss.

Researchers suggest that blood sugar levels outside of healthy ranges may damage nerves and small blood vessels in the inner ear. Over time, this damage may affect hearing and result in hearing loss.

If people have diabetes or prediabetes, they need to attend regular hearing tests and manage their blood sugar levels. If a person has any symptoms of hearing loss, they should contact a doctor as soon as possible to find out the cause and start any treatment.

Individuals can also attempt to prevent hearing loss by using earplugs around loud noise.