High prevalence of disabling hearing loss in young to middle-aged adults with diabetes

  • Vera-Genevey HlayisiEmail author
  • Lucretia Petersen
  • Lebogang Ramma
Original Article


South Africa has one of the highest diabetes prevalence numbers in Sub-Saharan Africa with more than 2 million diagnosed. There is an increase in evidence linking diabetes with hearing loss. This study aimed to determine prevalence and characterize the nature of hearing loss in patients with diabetes. An observational matched groups design was utilized with a total of 192 participants, 110 patients with diabetes (cohort) and 82 patients without diabetes (control). Pure tone audiometry findings showed a significantly higher prevalence of hearing loss in those with diabetes (55%) when compared to those without (20%) diabetes (p < .001). Further, in patients with diabetes (and diagnosed with hearing loss), the majority (74%) presented with sensorineural hearing loss. There was a higher number of participants with disabling hearing loss (pure tone average (PTA) 0.5, 1, 2 and 4 kHz > 41-dB hearing level (HL) in the better ear) in those with diabetes (n = 48) than those without (n = 10). Distortion product otoacoustic emission assessments showed significantly higher percentages of abnormalities (p < 0.01) in those with diabetes compared to those without diabetes. Findings of this study showed that participants who were diagnosed with diabetes had a higher proportion of disabling hearing loss when compared to those without diabetes. The findings of this study further strengthen the suggestion that hearing loss should be considered as a comorbidity associated with diabetes.


Hearing loss Diabetes Disabled persons Prevalence 



The authors would like to acknowledge and thank the Polokwane Provincial Academic Hospital audiology staff (data collection site) for their cooperation in the study as well as the Provincial Department of Health in Limpopo for granting permission for the study.

Author contribution

V. Hlayisi: concepts, design, definition of intellectual content, literature search, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, and manuscript review.

L. Petersen: definition of intellectual content, literature search, manuscript preparation, manuscript editing, and manuscript review.

L. Ramma: definition of intellectual content, literature search, data analysis manuscript preparation, manuscript editing, and manuscript review.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants

All procedures performed in the study were in accordance with the 1964 Helsinki declaration (and its later amendments or comparable ethical standards) as well as the ethical standards of the institutional committee. Ethics clearance was obtained from the University of Cape Town’s Faculty of Health Sciences Human Research Ethics Committee (HREC/Ref:134/2015) prior to the commencement of the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    World Health Organization. World health statistics. 2012 Accessed 15 April 2014.
  2. 2.
    World Health Organization. Non-communicable diseases [Fact sheet]. 2016. Accessed 25 May 2014.
  3. 3.
    Frisina T, Mapes F, Kim S, Frisina R. Characterization of hearing loss in aged type 2 diabetics. Hear Res. 2006;211:103–13. Scholar
  4. 4.
    Rheeder P. Type 2 diabetes: the emerging epidemic. S Afr Fam Pract. 2006;48(10):20. Accessed from Google Scholar
  5. 5.
    Peer N, Kengne AP, Motala A, Mbanya J. Diabetes in the Africa region: 2013 update for the IDF diabetes atlas. Diabetes Res Clin Pract. 2013;
  6. 6.
    Jáuregui-Renaud K, Sánchez B, Olmos A, González-Barcena D. Neuro-otologic symptoms in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2009;84:e45–7. Scholar
  7. 7.
    Panchu P. Auditory acuity in type 2 diabetes mellitus. Int J Diabetes Dev Ctries. 2008;28:114–20.CrossRefGoogle Scholar
  8. 8.
    Pemmaiah K, Srinivas D. Hearing loss in diabetes mellitus. Int J Collab Res Intern Med Public Health. 2011;3:725–32. Accessed from Google Scholar
  9. 9.
    Thimmasettaiah NB, Shankar R. A one year prospective study of hearing loss in diabetes in general population. Transl Biomed. 2012;
  10. 10.
    Bainbridge K, Hoffman J, Cowie C. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Surveys 1999-2004. Ann Intern Med. 2008;149:1–10. Scholar
  11. 11.
    Botelho CT, Carvalho S, Silva IN. Increased prevalence of early cochlear damage in young patients with type 1 diabetes detected by distortion product otoacoustic emissions. Int J Audiol. 2014;53:402–8. Scholar
  12. 12.
    Olege E, Okorot F. Type 2 diabetes and hearing loss in black Africans cardiovascular therapies and their role in diabetic eye disease. Diabet Med. 2005;22:664–6. Scholar
  13. 13.
    Bagli Z. Multicultural aspects of hearing loss. In: Battle D, editor. Communication disorders in multicultural and international populations. Missouri: Elsevier Inc; 2012. p. 208–42.CrossRefGoogle Scholar
  14. 14.
    Kakarlapudi V, Sawyer R, Staecker H. The effect of diabetes on sensorineural hearing loss. Otol Neurotol. 2003;24:382–6. Accessed from CrossRefGoogle Scholar
  15. 15.
    Mozaffari M, Tajik A, Ariaei N, Ali-Ehyaii F, Behnam H. Diabetes mellitus and sensorineural hearing loss among non-elderly people. East Mediterr Health J. 2010;16:947–52. Scholar
  16. 16.
    Bhaskar KN, Chalihadan S, Vaswani R, Rehaman CPA. Clinical and audiometric assessment of hearing loss in diabetes mellitus. Int J Sci Stud. 2014;2(4):2–17. Accessed from Google Scholar
  17. 17.
    World Health Organization. Non-communicable diseases [Fact sheet]. 2015. Accessed 25 May 2014.
  18. 18.
    Clark JG. Uses and abuses of hearing loss classification. ASHA. 1981;23:493–500. Accessed from Google Scholar
  19. 19.
    Timmer B. It may be mild, slight, or minimal, but it’s not insignificant. Hearing Review. 2014;21:30–3. Accessed from Google Scholar
  20. 20.
    Kaderavek J, Pakulski L. Minimal hearing loss is nor minimal. Teach Except Child. 2002;34:14–8. Scholar
  21. 21.
    Arlinger S. Negative consequences of uncorrected hearing loss—a review. Int J Audiol. 2003;42:17–20. Scholar
  22. 22.
    Mitchell P, Gopinath B, McMahon RE, Wang BJ, Leeder S. Relationship of type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss. Diabet Med. 2009;26:483–8. Scholar
  23. 23.
    Akinpelu V, Ibrahim F, Waissbluth S, Daniel S. Histopathologic changes in the cochlea associated with diabetes mellitus—a review. Otol Neurotol. 2014;35:674–774. Scholar
  24. 24.
    Sparring V, Burström K, Nyström L, Wahlström R, Jonsson P, Östman J. Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15-34 years: a Swedish population based study using EQ-5D. Public Health. 2013;
  25. 25.
    Kim M, Zhang Y, Chang Y, Ryu S, Choi Y, Kwon M, et al. Diabetes mellitus and the incidence of hearing loss: a cohort study. Int J Epidemiol. 2017:dyw243.
  26. 26.
    Sharashenidze N, Schacht J, Kevanishvili Z. Age-related hearing loss: gender differences. Georgian Med News. 2007;144:14–8. Accessed from Google Scholar

Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  1. 1.University of Cape Town, Faculty of Health Sciences, Department of Health and Rehabilitation Sciences, Division of Communication Sciences and DisordersObservatorySouth Africa

Personalised recommendations