Neuropathy in patients with type 2 diabetes associated with hearing loss

With increased Hba1c (glycated haemoglobin) levels and worsening severity of neuropathy, the researchers found a worsening HL severity. They suggested that patients with moderate to severe neuropathy might benefit from screening for hearing loss.

Type 2 diabetes mellitus (T2DM) is one of the significant health problems affecting more than 463 million individuals globally. An increased prevalence of T2DM may likely lead to increased diabetes-related complications. Several population-based studies have linked type 2 diabetes with hearing loss. Hearing loss can significantly impact the quality of life and emotional and economic impact. Also, hearing loss and diabetes have been reported to be independent risk factors for dementia development.

Strong evidence suggests that timely diagnosis and hearing aids use can significantly improve the quality of life, reduce depression, improve communication, and rate of cognitive decline in patients with hearing loss. This makes it imperative to identify type 2 diabetes patients at risk of developing hearing loss so that effective screening can be done for diagnosis and prompt treatment initiation can follow.

Against the above background, Abin M Abraham, Assistant Professor, Department of Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India, and colleagues aimed to assess the prevalence of hearing loss in type 2 diabetes mellitus patients and its relationship with severity and presence of diabetic neuropathy.

After informed consent hearing threshold was evaluated using pure tone audiometry (PTA). The study included patients aged 30 to 60 years with type 2 diabetes. They were categorized into three groups; Group I included patients without neuropathy, Group II comprised patients with mild neuropathy; and Group III included patients with moderate and severe neuropathy.

The study revealed the following findings:

• Of the 200 patients recruited, the prevalence of HL was overall 81%.
• The prevalence was 66.7% in Group I, 80.9% in Group II, and 87.6% in Group III.
• Among patients with moderate to severe neuropathy (group III), 33.3% had clinically significant HL (CSHL).
• Age, presence of neuropathy, gender, and severity of neuropathy were associated with an increased risk of developing HL.

Findings showed that age, nephropathy, and diabetic neuropathy were associated with hearing loss in patients with type 2 diabetes. The severity of hearing loss worsened with increased Hba1c levels and worsening severity of neuropathy.

"Screening for hearing loss using simple and cost-effective measures like self-reported screening questionnaires might be beneficial for patients with moderate to severe neuropathy," the researchers concluded.

Reference:

Abraham AM, Jacob JJ, Varghese A. Prevalence of Hearing Loss in Type 2 Diabetes Mellitus and Its Association with Severity of Diabetic Neuropathy and Glycemic Control. J Assoc Physicians India 2023;71(6):14–19