Diabetes is a very common condition that affects how well your body regulates blood sugar levels, and can affect various aspects of your health. 
In terms of your hearing, it’s the effect that diabetes can have on your blood vessels and nerves that can cause issues with your ears, sometimes causing an ‘injury’ to the inner ear which can affect your hearing. 1-7  
Here, we take a look at how diabetes can impact your hearing, and what you can do to maintain your hearing health.

Can high blood sugar cause hearing loss?

In short, yes.7 While it’s unclear exactly what happens, scientists have found that high blood sugar levels can damage the small blood vessels in the inner ear, affecting the blood circulation in that part of your ear.8 Unstable blood glucose levels can also put you at greater risk of hearing loss.9

High blood sugar can affect the tiny hair cells in your ear, the protective covering of the nerves, or block certain sensory receptors in the ear.10, 11,12

If you have diabetes you may start to notice subtle changes to your hearing, particularly with high-frequency sounds.13, 14 For example, you may find vowel sounds easy to identify, but the letters f, s, t and z, may be more difficult for you to notice. Or sounds with higher octaves, like birdsong, may not be as clear.

Can low blood sugar cause hearing loss?

Your hearing can also be affected if you have low blood sugar, and we know a little more about why this is.15

Research has found that low blood sugar is one of the factors that can create a chemical imbalance in the fluid found in your ear. 16, 17 This fluid has a very specific make-up which allows the cochlea to function properly, so if this is altered it can change the way your ear processes sounds. 

If you have low blood sugar for a long period and suspect any change in your hearing, it’s a good idea to get your hearing checked. Read about the symptoms of hearing loss here.

Will diabetes increase the risk of ear infections?

People with diabetes have an increased risk of infection and related complications. One type of common ear infection is malignant otitis externa, which only affects diabetic people.

This is an infection of the external ear canal and skull base, which usually affects older people with diabetes.18 The infection is caused by bacteria and can spread to surrounding areas (like the jawbones or face) if it’s left untreated. 19 

Sudden hearing loss can be a symptom of this infection, so you should get your ears checked out quickly if you are diabetic and experience sudden hearing loss. 

Diabetic people can also be at a higher risk of developing inner ear infections due to excess insulin.20 

So controlling your insulin levels and having regular check-ups are important to avoid both of these types of infection. 21, 22

How to protect your ears if you have diabetes

  • Keep your blood sugar levels under control and exercise regularly 
  • You may be more susceptible to infection so you should seek treatment as soon as possible if you think you have any injuries or infections in your ears
  • Protect your ears from prolonged exposure to high noise levels
  • Quit smoking as it can increase the risk of hearing loss21

If you have diabetes you may experience hearing loss to some extent, but maintaining stable blood sugar levels should help you reduce the impact of your diabetes on your hearing. 

If you have any concerns about your hearing, or if you just want to see how your hearing is, you might benefit from a free hearing test. Our audiologists can test your hearing and answer any questions you might have. To book an appointment for a hearing test, find your nearest store and book online.

To learn out more about hearing loss, you can find more information and articles on our hearing loss hub.

References

1.  Friedman SA, Schulman RH, Weiss S. Hearing and diabetic neuropathy. Arch Intern Med 1975;135 (4):573–576.

2. Axelsson A, Sigroth K, Vertes D. Hearing in diabetics. Acta Otolaryngol Suppl 1978;Vol. 356:1–23

3. Taylor IG, Irwin J. Some audiological aspects of diabetes mellitus. J Laryngol Otol 1978;92(2):99–113.

4. Kurien M, Thomas K, Bhanu TS. Hearing threshold in patients with diabetes mellitus. J Laryngol Otol 1989;103(2):164–168. 

5. Erdem T, Ozturan O, Miman MC, Ozturk C, Karatas E. Exploration of the early auditory effects of hyperlipoproteinemia and diabetes mellitus using otoacoustic emissions. Eur Arch Otorhinolaryngol 2003;260(2):62–66.

6. Dalton DS, Cruickshanks KJ, Klein R, Klein BE, Wiley TL. Association of NIDDM and hearing loss. Diabetes Care 1998;21(9):1540–1544.

7. Helzner EP, Contrera KJ. Type 2 Diabetes and Hearing Impairment. Curr Diab Rep. 2016;16(1):3. doi:10.1007/s11892-015-0696-0 

8. Elangovan S, Spankovich C. Diabetes and Auditory-Vestibular Pathology. Semin Hear. 2019;40(4):292-299. doi:10.1055/s-0039-1697033

9. Sommer J, Brennan-Jones CG, Eikelboom RH, et al. A population-based study of the association between dysglycaemia and hearing loss in middle age [published correction appears in Diabet Med. 2017 Oct;34(10 ):1488]. Diabet Med. 2017;34(5):683-690. 

10. Kim MB, Zhang Y, Chang Y, et al. Diabetes mellitus and the incidence of hearing loss: a cohort study [published correction appears in Int J Epidemiol. 2017 Apr 1;46(2):727]. Int J Epidemiol. 2017;46(2):717-726. doi:10.1093/ije/dyw243 

11. Makishima K, Tanaka K. Pathological changes of the inner ear and central auditory pathway in diabetics. Ann Otol Rhinol Laryngol. 1971;80(2):218-228. doi:10.1177/000348947108000208 

12. Xing Y, Ming J, Liu T, Zhang N, Zha D, Lin Y. Decreased Expression of TRPV4 Channels in HEI-OC1 Cells Induced by High Glucose Is Associated with Hearing Impairment. Yonsei Med J. 2018;59(9):1131-1137. doi:10.3349/ymj.2018.59.9.1131 

13. Li YH, Liu B. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018;53(3):223-226. doi:10.3760/cma.j.issn.1673-0860.2018.03.012

14. Ashkezari SJ, Namiranian N, Rahmanian M, Atighechi S, Mohajeri-Tehrani MR, Gholami S. Is hearing impairment in diabetic patients correlated to other complications?. J Diabetes Metab Disord. 2018;17(2):173-179. Published 2018 Sep 26. doi:10.1007/s40200-018-0357-3 

15. Bener A, Al-Hamaq AOAA, Abdulhadi K, Salahaldin AH, Gansan L. Interaction between diabetes mellitus and hypertension on risk of hearing loss in highly endogamous population. Diabetes Metab Syndr. 2017;11 Suppl 1:S45-S51. doi:10.1016/j.dsx.2016.09.004 

16. Mendelsohn M, Roderique J. Cationic changes in endolymph during hypoglycemia. Laryngoscope. 1972;82(8):1533-1540. doi:10.1288/00005537-197208000-00016

17. Albernaz PL. Hearing Loss, Dizziness, and Carbohydrate Metabolism. Int Arch Otorhinolaryngol. 2016;20(3):261-270. doi:10.1055/s-0035-1558450 

18. Karaman E, Yilmaz M, Ibrahimov M, Haciyev Y, Enver O. Malignant otitis externa. J Craniofac Surg. 2012;23(6):1748-1751. doi:10.1097/SCS.0b013e31825e4d9a

19. Bhandary S, Karki P, Sinha BK. Malignant otitis externa: a review. Pac Health Dialog. 2002;9(1):64-67.

20. Mangabeira Albernaz PL, Fukuda Y. Glucose, insulin and inner ear pathology. Acta Otolaryngol. 1984;97(5-6):496-501. doi:10.3109/00016488409132927

21. Wheat LJ. Infection and diabetes mellitus. Diabetes Care. 1980;3(1):187-197. doi:10.2337/diacare.3.1.187

22. Lee SK, Lee SA, Seon SW, et al. Analysis of Prognostic Factors in Malignant External Otitis. Clin Exp Otorhinolaryngol. 2017;10(3):228-235. doi:10.21053/ceo.2016.00612

Understanding hearing loss
Treatment of hearing loss
Symptoms of hearing loss