December 4th, 2014

Diabetes: Can You Hear Me Now?

Diabetes: Can You Hear Me Now?

December 4, 2014

It has been known for quite some time that uncontrolled diabetes can cause many complications including cardiovascular disease, kidney damage, impaired wound healing, and vision changes. But did you know that uncontrolled diabetes can affect a person’s hearing? According to the American Diabetes Association, people with diabetes are twice as likely and people with prediabetes have a 30% increased likelihood of hearing loss compared to people with normal glucose levels.1

There are many theories as to why hyperglycemia can cause hearing loss. One of the theories is that it is caused by damage to the microvasculature of the cochlea. This is supported by the correlation between hearing loss and increased creatinine levels, which shows that there is existing damage to the microvasculature elsewhere in the body. There is also a correlation between an increase in Stromal cell-derived factor 1a (SDF-1a), which is a marker of microvasculature damage, and hearing loss in people with diabetes.2 Another theory is that uncontrolled diabetes causes oxidative stress in the body. Nitric oxide, a vasodilator, was found to be decreased in diabetes patients that experienced hearing loss.3-4 The last prominent thought process is that glycosylation of myelin occurs in the peripheral nervous system causing vascular endothelial damage.2

One surprising fact is that hearing loss does not seem to be correlated with the age of the person with diabetes. Research has shown that the length of having diabetes, especially uncontrolled diabetes, is more important than age.5 Studies have shown that there is a correlation between increased A1C and increase prevalence of hearing loss. In one study, patients who experienced hearing loss had an average A1C of 12.2%.5

Risk factors for hearing loss in people with diabetes include:

High A1C level
Existing microvascular complications, such as peripheral neuropathy, kidney damage, etc.
Long duration of diabetes
Increased SDF-1a level
Now that we know hearing loss is another common complication of diabetes, it may be prudent to re-educate patients on the importance of continually controlling their glucose levels in order to prevent these complications. In addition, the recommendation of an annual hearing exam should be included in the monitoring parameters for diabetes-related microvascular complications. Even though hearing loss may develop at a slower pace, the sooner it is identified the earlier interventions can be made.

How does that sound to you?

 

Susan Cornell, PharmD, CDE, FAPhA, FAADE, is an associate professor of pharmacy practice and assistant director of experiential education at the Midwestern University Chicago College of Pharmacy. She is also a clinical pharmacist/certified diabetes educator with Dupage Community Clinic in Wheaton, IL.

Daniel Morrow, 2014 PharmD Candidate, co-authored this post.

References:

1. Diabetes and hearing loss. American Diabetes Association. www.diabetes.org. Accessed July 23, 2014.

2. Hong O, Buss J, Thomas E. Type 2 diabetes and hearing loss. Dis Mon. 2013;59(4):136-146.

3. Frisina ST, Mapes F, Kim S, Frisina DR, Frisina RD. Characterization of hearing loss in aged type II diabetics. Hear Res. 2006;211(1–2):103-113.

4. Sakuta H, Suzuki T, Yasuda H, Ito T. Type 2 diabetes and hearing loss in personnel of the Self-Defense Forces. Diabetes Res Clin Pract. 2007;75(2):229-234.

5. Lerman-Garber I, Cuevas-Ramos D, Valdes S, et al. Sensorineural hearing loss—a common finding in early-onset type 2 diabetes mellitus. Endocr Pract. 2012;18(4):549-557.

 

Comments:  Dr. Neel,

This article was just too good to pass by.   It positively emphasizes the VERY IMPORTANT fact that knowing what your body is doing in the natural process of manageing your blood sugar.  Very very important and you should take notice that every person is susceptable to Diabetes.  That Diabetes, even though higher risks are in obese patients with distructive life styles, is a secret killer looming in the background to all people.  There are seveal points that every body, over 40 years of age,  should monitor dillagently and respond to if outside of suggested parameters:

1.  Annual hearing test, Eye exam & Physical

2.  Constant fatigue

3.  Excessive thurst

4.  Blood Sugar Values (you will have to buy a cheap monitor device)

      (check MORING finger stick same time each week (normal 65 to 105)  ... If value above 150 take it daily if value stays on or around 150 go to the Doctor for evaluation.)

I know you find this unnecessary and troublesome but if it extends your productive life, keeps you from developing Cardiovascular Disease, Blindness, Hearing Loss and loss of your limbs it is a very.  People live longer each year which is good and is a sure fire reason to work maintaning your health so that you can be one of these very old people that keeps up an enjoyable life style and pride of reaching a very old age and continue to enjoy it.