The American Diabetes Association (ADA) has recognized hearing loss as being more common in people with diabetes and added audiology to its table on referrals for initial diabetes care management in its recent updated Standards of Medical Care in Diabetes-2021 published in the January 2021 edition of Diabetes Care, the organization’s professional magazine.
The two key places in the ADA document addressing hearing loss management are at the end of Table 4.4 (page S46) where it lists “Audiology, if indicated” as a bullet point, and the section on “Sensory Impairment” (page S49):
Hearing impairment, both in high-frequency and low- to midfrequency ranges, is more common in people with diabetes than in those without, with stronger associations found in studies of younger people. Proposed pathophysiologic mechanisms include the combined contributions of hyperglycemia and oxidative stress to cochlear microangiopathy and auditory neuropathy. In a National Health and Nutrition Examination Survey (NHANES) analysis, hearing impairment was about twice as prevalent in people with diabetes compared with those without, after adjusting for age and other risk factors for hearing impairment. Low HDL cholesterol, coronary heart disease, peripheral neuropathy, and general poor health have been reported as risk factors for hearing impairment for people with diabetes, but an association of hearing loss with blood glucose levels has not been consistently observed. In the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort, time-weighted mean A1C was associated with increased risk of hearing impairment when tested after long-term (.20 years) follow-up. Impairment in smell, but not taste, has also been reported in individuals with diabetes.
The inclusion of hearing impairment represents a significant victory for hearing healthcare and the efforts of The Audiology Project, led by its executive director Kathy Dowd, AuD, which promotes audiology-based medical management for chronic diseases. In recent years, The Audiology Project has devoted a great amount of effort in educating stakeholders in diabetes about the links between the disease and hearing loss.
Source: Diabetes Care, January 2021 edition