Hearing Loss in Diabetic Patients: A Prospective Comparative Study

Background Diabetes mellitus is a chronic disease that causes an array of dysfunctions, mainly because of its neuropathic and microvascular complications. This study was based on the hypothesis that these complications can lead to hearing loss in diabetic patients. The study also evaluates other influences on hearing loss in diabetic patients. Objectives The objective is to assess the prevalence of sensorineural hearing loss among diabetic patients and to analyze whether other factors contribute to worsening hearing loss among diabetics. Methods A prospective study was conducted among diabetic patients aged 35-60. A total of 86 patients were involved in this study. Results The prevalence of hearing loss among diabetic people in our study was 70.9%. Most hearing loss patients had mild sensorineural hearing loss, with a significant high-frequency slope or dip. There is a higher chance of hearing loss among diabetic patients if they have associated hypertension as well. No association between HbA1c level and duration of diabetes was established. As the age of the diabetic patient rises, there is a notable increase in the chance of having hearing loss as well, even though it was not statistically proven. Conclusions The hyperglycemic effects causing cochlear dysfunction start early in the phase of diabetes, and many people are unaware of their hearing deprivation. This might be because most of the affected people have mild sensorineural hearing loss. Early detection and intervention are needed to prevent the progression of this morbid condition.

Context: Evaluation of hearing loss with diabetic control. Aims: The aim of this study was to profile the audiologic findings of diabetic patients by assessing the degree of hearing loss and the presence/absence of otoacoustic emissions (OAEs); to correlate the factors, namely, age, gender, glycemic status, and duration of diabetes mellitus with hearing loss. Settings and Design: The study was done at a tertiary care hospital and a cross-sectional study design was employed. Materials and Methods: Forty known diabetic patients who satisfied the selection criteria and consented were included in the study. Three tests were carried out, namely, pure tone audiometry, immittance audiometry, and OAEs. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 11.5. For the current study, median, interquartile range (IQR), frequency, and percentage were considered. Results: Majority of the patients had bilateral sensorineural hearing loss ranging in severity from minimal to mild degree. Median pure tone average (PTA) values were less in patients with good glycemic status as compared to those with poor glycemic status. OAEs were absent in 30% of the subjects. Age had a contributing effect on raising the hearing threshold but gender and duration of diabetes did not show such an effect. Conclusion: Diabetic patients are at an increased risk of developing sensorineural hearing loss.

The relationship between sensorineural hearing loss (SNHL) and Diabetes mellitus has been known since more than 150years. The pathophysiology of diabetes related hearing loss is speculative. Hearing loss is usually, bilateral, gradual onset, affecting higher frequencies. This study aims at knowing the prevalence of SNHL in DM and its relation to age, sex, duration of DM and control of DM. A total of 50 type 2 diabetics of age group 30-65years were involved in the study. FBS, PPBS, HbA1c of all the subjects were done and later subjected to PTA. The type and severity of hearing loss was noted. Occurrence of SNHL was later compared with age, sex, duration, and control of DM. Sensorineural hearing loss was found in 66% of type II diabetic patients and 34% were found normal. Out of 50 diabetes mellitus patients, 33 patients had SNHL. All cases of SNHL detected were of gradual in onset and no one had hearing loss of sudden onset. Normal hearing was found in 34% of patients, whereas 54% of patients had mild hearing loss and 12% of patients had moderate hearing loss. Association of hearing loss of DM patients with sex of the patient is insignificant. However there is significant association between older age group, longer duration and uncontrolled DM with that of SNHL. In subjects with HbA1c more than 8 and duration of diabetes mellitus more than 10years prevalence of SNHL is more than 85%, which is statistically significant. Sensorineural hearing loss in diabetes mellitus is gradually progressive involving high frequency thresholds. Hearing threshold increases with increasing age duration of diabetes and also high level of HbA1c greater than 8%.

Background: Hearing loss in Diabetic patients is global problem WHO report has a suggestion that 50% of hearingloss in Diabetic patients is preventable. Hence various grades of hearing loss has to be evaluatedMethod: 250 hearing loss patients,aged between 20 to 50 years were studied by pure tone audiometry, byaudiometry degree, type and configuration of hearingwas assessed. General examination was done by otoscopyfollowed by pure tone audiometry in which manual audiometry was used.Results: 123 (49.2%) had moderate loss, 89 (35.6%) moderate severe, 38 (15.2%) severe hearing loss, Associatedclinical manifestation were 86 (34.4%) had parasthesia, 60 (24%) had skin disease, 50 (20%) had visual problems,54 (21.6%) had lack of sleep.Conclusion: In this pragmatic study it is concluded that there is strong correlation between Diabetes mellitusand hearing threshold levels especially at higher frequencies. Long duration and uncontrolled diabetes has moreimplications over hearing threshold. This study will help the ENT surgeon to diagnose the severity of hearing lossand treat efficiently to avoid morbidity mortality and social withdrawl.

Objective: to evaluate the effect of antioxidant vitamins on hearing loss in diabetic patients. Patients and methods: Sixty type 2 diabetic patients with positive pure tone audiogram (PTA) enrolled in the study and divided into two groups: each group consists of thirty patients, group one was put on antioxidant therapy, and group two on placebo therapy, for 2 months duration. Thirty healthy individuals were kept as a control. Fasting blood sugar (FBS), and malondialdehyde (MDA) were measured in all groups. MDA and PTA were repeated after therapy. Results: The FBS and MDA are higher in diabetic patients, and beneficial effects of the administration of vitamin E and C combination on the oxidative stress and significant improvement, with mean differences of 12.5±7.79 decibel (dB), in the sensorineural hearing loss (SNHL) in diabetic patients were obtained. Conclusion: the present study demonstrated that diabetic patients have exaggerated oxidative stress, and administration of vitamin E and C combination had beneficial effect on the oxidative stress, and on the SNHL in diabetic patients with mean differences of 12.5±7.79 dB (p<0.001).

INTRODUCTION Hypertension is among non-communicable diseases worldwide and it has been associated with sensorineural hearing loss. Almost 1.39 billion people (1 out of 4 adults) have hypertension and this figure is expected to increase. In Sub-Saharan Africa, hypertension is the leading cause of death and disability. Hypertension is associated with sensorineural hearing loss by compromising the blood supply in the cochlea. MATERIALS AND METHODS An assessment of the proportion and patterns of sensorineural hearing loss among hypertensive patients was conducted. 191 patients aged 18 years and above were recruited. History and physical examination including blood pressure, and otoscopy were done. Pure tone audiometry (PTA) was conducted. RESULTS Patients aged from 36 to 88 years with a mean age of 60 years and a standard deviation of 10. The patients aged between 61–76 years accounted for 85 (44.5%), whereas 29–44 and &gt; 76 years accounted for 12 (6.3%) each. The female-to-male ratio was 1:1. Sensorineural hearing loss was detected in 144 (75.4%), commonly above 76 years of age which was 11 (91.7%. Mild sensorineural hearing loss was the most common degree revealed. There was no relationship between the degree of sensorineural hearing loss and the grades of hypertension (p-value of 0.113). No relationship between the duration of hypertension with the severity of hearing loss, p-value =0.369. CONCLUSION The prevalence of sensorineural hearing loss among hypertensive patients was 75.4%. The bilateral and mild degree was the commonest presentation. Increasing age was found to be associated with increased hearing loss. The duration and grade of hypertension were not related to the severity of hearing loss.

Veterans with diabetes will have significantly greater hearing loss than nondiabetic veterans. The association between diabetes and hearing loss remains unclear despite the volume of research that has been devoted to the question. Often, differences in hearing thresholds between diabetic and nondiabetic patients are confounded by age and noise exposure. In this 5-year prospective study, 342 diabetic veterans and 352 nondiabetic veterans from the Portland VA Medical Center in Oregon were tested on a variety of audiometric measures, including pure-tone thresholds. Age and noise exposure were accounted for in the analyses. There was a trend toward greater hearing loss in diabetic patients 60 years of age and younger across the frequency range. These differences were statistically significant only in the highest frequencies tested (10, 12.5, 14, and 16 kHz). The effects of both diabetes and noise exposure on high-frequency hearing thresholds were dependent on age. For patients older than 60 years, the mean thresholds were not significantly different. These results suggest that diabetic patients 60 years old or younger may show early high-frequency hearing loss similar to early presbycusis. After age 60, difference in hearing loss between diabetic and nondiabetic patients was reduced.

Background: Hearing loss is considered as one of the complications in diabetic patients. However, studies reported conflicting results on the relationship between diabetes and hearing loss. Objectives: This study aimed to investigateand compare the prevalence of hearing loss in patients with diabetes mellitus and a group of non-diabetic people. Materials and Methods: This study was conducted on 80 patients with diabetes and 80 non-diabetic subjects.Subjects in the case group were selected among the diabetic patients registered in the diabetes centers of Isfahanprovince. Subjects in the control group were selected among non-diabetic individuals referring to the blood bank todonate blood. The instrument used for data collection included of questions on the subjects demographics and a special form for recording the results of the subjects’ laboratory examinations including HbA1c, TSH, Cr and theresult of the audiometric examinations. Data analysis was performed using descriptive statistics, chi-square test andt-test or nonparametric equivalents. Results: Compared with non-diabetic subjects, hearing loss in sounds with high frequencies was more common in patients with diabetes (P value = 0.001), the mean creatinine was significantly different in diabetic patients with and without hearing loss at noise frequencies of 4 KHz and 8 KHz (P value< 0.05). However, hemoglobin A1C, duration of diabetes and BMI were not significantly associated with hearing loss. Conclusion: Hearing impairment in high frequency sounds is more common in diabetics than healthy individuals.The severity of hearing loss in patients with diabetes is also associated with the levels of creatinine. Keywords: Hearing Loss, Diabetes mellitus, Audiometry

Introduction: Type 2 diabetes mellitus can give rise to several complications in the body, including electrolyte imbalance. In this study, we aim to find the association of hypomagnesemia with the duration and severity of diabetes. Understanding the association between magnesium and diabetes may assist in the early detection of hypomagnesemia and help manage the complications associated with electrolyte imbalance.Methods: This cross-sectional study was conducted in the internal medicine department of a tertiary care hospital in Pakistan from January to March 2021. Three hundred (n = 300) patients with a confirmed diagnosis of type 2 diabetes were enrolled in the study after informed consent via consecutive convenient non-probability sampling. Three hundred (n = 300) patients were included in the study as a reference group. Blood was drawn via phlebotomy and sent to the laboratory to assess glycated hemoglobin (HbA1c) and magnesium levels.Results: In uncontrolled diabetic patients, mean magnesium level was significantly lower as compared to diabetic patients with good glycemic control (1.34 ± 0.3 mg/dL vs. 1.81 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with uncontrolled diabetes, compared to the controlled diabetic group (65.8% vs. 50.8%; p-value: 0.009). In patients with a duration of diabetes of more than 10 years, the mean magnesium level was significantly lower, compared to patients with less than 10 years of diabetes (1.32 ± 0.3 mg/dL vs. 1.78 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with diabetes for more than 10 years (64.7% vs. 51.9%; p-value: 0.02).Conclusion: Hypomagnesemia is prevalent in diabetes and is directly related to the severity and duration of diabetes. It is important to include electrolyte screening as a part of routine screening in diabetic patients for early detection and management of electrolyte imbalance, including hypomagnesemia.

Introduction: The incidence of bilateral sensorineural hearing loss is quite notable in live births worldwide. Among the etiologies, the primary aetiology is thought to be genetic, followed by non heritable, and unknown. Aim: To study the effect of consanguinity on audiological profile in children presented with non syndromic sensorineural hearing loss. Materials And Methods: This cross-sectional study was conducted in the Department of Ear Nose Throat, McGANN Teaching District Hospital (Shimoga Institute of Medical Sciences), Shivamogga, Karnataka, India, from January 2019 to December 2020, among 95 children with non syndromic sensorineural hearing loss. A Pure Tone Audiometry (PTA) test was done for each patient both air conduction and bone conduction thresholds were tested using different transducers. An audiogram was collected and the degree of hearing loss of each patient was analysed. Statistical tests were performed using Statistical Package for Social Sciences (SPSS) version 34.0, Kruskal-Wallis test, oneway Analysis of Variance (ANOVA) was used for comparing the difference in PTA followed by the Mann-Whitney U test. Results: The mean age of the study population was 9.7 years; 39 subjects were female, and 56 were male. The PTA among the study population showed asymmetric audiograms in 17 (17.9%) children. A majority (60, 63%) of the participants were born out of consanguineous marriage. Total 80 (84.2%) children had bilateral hearing loss, among which 58 (72.5%) were cases of bilateral profound. One-way ANOVA showed that there was an overall significant difference between the consanguinity and non consanguinity groups and post-hoc analysis with the Mann-Whitney U test revealed a significant difference between the different degrees of consanguineous marriage. Conclusion: Consanguinity affects the audio profile (PTA) among the non syndromic hearing-impaired children.

Introduction Type 2 diabetes mellitus affects millions globally and frequently leads to ocular complications. This study investigated the prevalence of dry eye disease in diabetic patients and examined whether tear film dysfunction correlates with diabetic retinopathy severity. Methodology We conducted a cross-sectional observational study at the Department of Ophthalmology, Regional Institute of Medical Sciences, Ranchi, from September 2023 to December 2024. We enrolled 153 consecutive patients with type 2 diabetes and assessed them using the Ocular Surface Disease Index questionnaire, tear break-up time measurement, Schirmer's test, and fluorescein staining. Diabetic retinopathy was graded using dilated indirect ophthalmoscopy. Results Among 153 diabetic patients (mean age 55.48 ± 8.66 years, 69.28% male), 64 (41.83%) had dry eye disease. Most cases were moderate severity (21.57%). Patients with dry eye had longer diabetes duration than those without (6.00 ± 2.88 vs 4.95 ± 2.03 years, t = 2.45, p = 0.01). Diabetic retinopathy was present in 48 cases (31.37%). Dry eye severity correlated significantly with retinopathy progression (χ² = 8.76, p < 0.05). Higher HbA1c levels are associated with increased dry eye prevalence (F = 12.34, p < 0.001), with mean HbA1c rising from 6.89 ± 0.49 in unaffected patients to 8.48 ± 1.24 in severe cases. Conclusion Dry eye disease is common among patients with type 2 diabetes. Advanced age, prolonged diabetes duration, and poor glycemic control are associated with higher dry eye prevalence. The strong correlation between diabetic retinopathy severity and dry eye suggests shared pathophysiological mechanisms. These findings support comprehensive ocular surface screening in diabetic patients alongside routine retinal examination.

To determine the annual incidence and clinically relevant risk factors for foot ulceration in a large cohort study of diabetic foot ulcer (DFU) patients and diabetes mellitus (DM) patients in China. To investigate a cohort of 1,333 patients comprising 452 DFU patients and 881 DM patients, who underwent foot screening, physical examination, and laboratory tests in eight hospitals. The patients were assessed at baseline in terms of their demographic information, medical and social history, peripheral neuropathy disease (PND) screening, periphery artery disease (PAD) screening, assessment of nutritional status, and diabetic control. One year later, the patients were followed up to determine the incidence of new foot ulcers, amputation, and mortality. By univariate analysis, statistically significant differences were found in age, location, gender, living alone (yes/no), occupation, smoking, hypertension, PND, PAD, nephropathy, retinopathy, cataracts, duration of diabetes, Glycosylated hemoglobin A (HbA1c), fasting plasma glucose level, postprandial blood glucose level, insulin level, blood urea nitrogen, creatinine, cholesterol, triglyeride, high density lipoprotein (HDL), serum albumin, white blood cell, and body mass index. A binary logistic regression model was used to examine which of these risk factors were independent risk factors for foot ulceration. A total of 687 (51.5%) of the 1,333 patients were followed up for an average of 12 months; there were 458 DM patients and 229 DFU patients. A total of 46 patients died during the follow-up period; 13 were DM patients, and 33 were DFU patients. Of the 641 patients, 445 (69.4%) patients were DM patients, and 196 (30.6%) were DFU patients. At follow-up, 36/445 DM patients (8.1%), and 62/196 DFU patients (31.6%), developed new ulcers; 10/196 DFU patients underwent an amputation. The annual incidence of ulceration for DM patients and amputation for DFU patients were 8.1 and 5.1%, respectively. The annual mortality of the DM patients and DMF patients were 2.8 and 14.4%, respectively. A binary logistic regression model was used to examine which risk factors were independent risk factors for foot ulceration during the follow-up period, and the final results showed that nephropathy (odds ratio 2.32), insulin level (odds ratio 3.136, 2.629), and decreased HDL (odds ratio 0.427) were associated with increased risks for foot ulceration. Complications of diabetes affecting the feet represent a serious problem in China. The incidence of foot ulcers and amputation are much higher than that of Western countries. More intensive surveillance and aggressive care following a diagnosis of DFU and earlier referral to specialty care might improve the patient outcome.

Introduction: Diabetes mellitus is one of the most common endocrine disorders in the world and is accompanied with many complications such as periodontal disorders as the most common complications of diabetes in the mouth. It is estimated that 1 million people worldwide are suffering from varying degrees of vitamin D deficiency, and some studies have linked it with periodontitis and diabetes. The purpose of this study is to investigate the relationship between periodontal disease in type 2 Diabetic patients and vitamin D deficiency in Iranian population. Materials and Methods: This cross-sectional study conducted on 74 Iranian patients admitted to Baqiyatallah hospital during the years 2017-2019. The type II diabetic patients were selected and non-volunteers patients and those who did not meet the inclusion criteria were excluded. Then, Necessary tests were evaluated in all patients. Patients were divided into two groups of with and without vitamin D deficiency. A questionnaire for periodontal disorders was completed by two different blinded periodontists. The collected data was analyzed using SPSS-21 software using Chi-square and T-test. Results: 44 males and 30 females were studied. 37 patients had vitamin D levels below 30 ng/ml. 83.8% of the patients had periodontal disorders. The frequency of periodontitis was higher in diabetic patients with vitamin D deficiency than in diabetic patients with normal levels of vitamin D. Periodontal disorders were also significantly correlated with duration of diabetes, age of patients and HbA1c. Conclusion: Periodontal disorder is more prevalent in patients with inadequate vitamin D serum levels. Screening for diabetic patients seems to be necessary both in terms of diagnosis of periodontitis and vitamin D deficiency.

Inner ear involvement has been reported in systemic rheumatic disease while detection of cochlin-specific antibodies has been reported in patients with idiopatic sensorineural hearing loss, suggesting cochlin's strong link to autoimmune hearing loss. The aim of this cross-sectional study was to calculate the prevalence of sensorineural hearing loss (SNHL) in patients with systemic rheumatic diseases, and to investigate any potential correlation with human antibodies to cochlin. Patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren's syndrome (SS) and systemic sclerosis (SSc) according to the criteria of American College of Rheumatology were included in the study. All patients underwent a complete ear-nose-throat physical examination and audiological evaluation with pure tone audiometry and impedance audiometry. Pure tone average was calculated, taking as a starting point the hearing loss in dB according to the recommendation 02/1 of "Bureau International d' Audiophonologie" (BIAP) so as an average hearing threshold value. Sera of all patients were tested for the presence of IgG antibodies to human cochline (COCH-IgG). Sex and age-matched healthy subjects were included as controls to each group. A total of 133 patients were studied; 60 with RA, 41 with SLE, 24 with SS and 8 with SSc. 61.4% of patients reported vertigo, 41% hyperacousis, 39% hearing loss, 38% tinnitus, 37.9% headache and 2.1% sensation of ear pressure with unremarkable otoscopy. The prevalence of SNHL calculated for patients affected by RA, SLE, SS and SSc was 66.6%, 31.71%, 54.17%, and 75% respectively. The calculated average hearing thresholds value in RA was increased in comparison to SLE (p < 0.05). In addition it was also higher in patients with RA and secondary SS, in comparison to RA patients (p > 0.05). There was statistically significant correlation of average hearing threshold with disease activity score 28 (DAS28) in RA, but no correlation observed with disease activity index (SLEDAI) in SLE. COCH-IgG antibodies were detected in only two samples. The results were compared with those of their respective sex and age-matched healthy subjects. Our study revealed increased prevalence of SNHL in patients with systemic autoimmune rheumatic disease but no correlation of hearing loss with COCHIgG antibodies. The mechanism of inner ear damage remains unknown; thus, additional prospective studies will be needed to elucidate its pathogenesis.

Repeated exposure to excessive noise will eventually lead to an irreversible increase in hearing thresholds. In theory, the damage reflects both the intensity of the noise and the duration of exposure. This is not linear with respect to duration of exposure; rather, the worker may experience a disproportionate loss in the early years of exposure. A prospective study surveying workers of the production section (i.e. most noise-exposed area) of a bottling factory was carried out in December 2003 and in December 2005. A self-administered questionnaire was used to extract information about worker's demographic characteristics, drug intake, and medical and occupational history, as well as information on the use of hearing protection devices. Noise mapping of the various departments of the factory was carried out. Otological examination, tympanometry and audiometry were also carried out on selected subjects. Eighty-four workers, 76 (90.5 per cent) men and eight (9.5 per cent) women, were studied. Their mean age was 33.0 +/- 7.6 years in 2003 and 35.0 +/- 7.6 years in 2005. The recorded noise levels in the factory production section ranged between 91.5 and 98.7 dBA. The prevalence of sensorineural hearing loss among workers was noted to be 64.9 and 86.9 per cent for test one (2003) and test two (2005), respectively. The degree of hearing deterioration within the two years of this study was 1.0-3.2 dB for the right ear and 1.6-3.4 dB for the left ear. This deterioration was at discrete frequencies. More than half (53.6 per cent) of the workers did not have a hearing protection device. Of the 46.4 per cent who did, only 38.5 per cent claimed to have used it regularly. These findings showed that there was a high prevalence of mild sensorineural hearing loss and significant hearing deterioration among workers, due to exposure to excessive noise over a two-year period. The study demonstrates the practical importance of serial audiometry for noise-exposed workers as a means of monitoring hearing deterioration. It is necessary to enforce existing occupational health laws in our industries in order to prevent noise-induced hearing loss, since it is eminently preventable.