Association between diabetes and hearing loss: A retrospective case-control study

Background Hearing loss is one of the complications of diabetes, but it is less recognized than other complications. And the guidelines do not mention hearing loss in diabetes.

Objective To explore the association between diabetes and hearing loss.

Methods Totally 222 patients with diabetes mellitus admitted to the Department of Endocrinology and Metabolism, General Hospital of Guangzhou Military Command of PLA, from September 2022 to March 2023 were collected and divided into normal hearing group and hearing loss group according to whether they had diabetes mellitus hearing loss. Ordinal multinomial Logistic regression analysis was used to evaluate the related risk factors for the severity of hearing loss in diabetic patients.

Results A total of 222 diabetic patients were enrolled, including 165 patients in the hearing loss group and 57 patients in the normal hearing group. There were 95 males (57.6%) in the hearing loss group and 38 males (66.7%) in the normal hearing group, with no significant difference between the two groups (P > 0.05). Compared with the normal hearing group, patients with hearing loss were older (62.79 ± 10.60 years vs 47.53 ± 10.17 years, P＜0.001), had longer disease duration (MIQR: 11.364.00 - 18.00 years vs 6.771.00 - 9.75 years, P < 0.001) and higher systolic blood pressure (133.85 ± 22.12 mmHg vs 126.21 ± 16.19 mmHg, P=0.006), higher creatinine/urinary microalbumin ratio (MIQR: 215.6883.47 - 347.89 mg/gCr vs 40.6821.55 - 59.81 mg/gCr, P=0.013). The coefficient of variation of blood glucose (MIQR: 30.2024.61 - 35.99% vs 27.9721.12 - 32.79%, P=0.034), the mean blood glucose (9.49 ± 2.03 mmol/L vs 8.73 ± 1.72 mmol/L, P=0.012), and the standard deviation of mean blood glucose were also higher (2.90 ± 1.01 mmol/L vs 2.48 ± 0.96 mmol/L, P=0.007). However, the estimated glomerular filtration rate was lower (MIQR: 82.19 69.00 - 98.00 mL/min·1.73m² vs 100.1589.25 - 118.00 mL/min·1.73m², P＜0.001). There were significant differences in diabetic retinopathy, diabetic kidney disease, hypertension and coronary heart disease between the two groups (all P < 0.05). Ordinal multinomial logistic regression analysis showed that the course of disease (OR=1.047, 95% CI: 1.015 - 1.080), SDBG (OR=1.337, 95% CI: 1.002 - 1.783), hypertension (OR=1.721, 95% CI: 1.017 - 2.913) and coronary atherosclerotic cardiopathy (OR=1.970, 95% CI: 1.019 - 3.806) were risk factors for hearing loss in patients with different severity of diabetes.

Conclusion The risk of hearing loss is higher in middle-aged (45-59 years old) diabetic patients, and the risk of hearing loss is higher when the duration of diabetes is less than 3 years, mainly presents as high-frequency hearing loss and mild hearing loss. The use of electrical audiometry combined with DPOAE can detect diabetic hearing loss earlier and more accurately.