Skip to main content

Type 2 Diabetes and Hearing Impairment

Current Diabetes Reports volume 16, Article number: 3 (2016) Cite this article

Abstract

Hearing impairment (HI) and type 2 diabetes are both highly prevalent disabling conditions. Type 2 diabetes has been modestly associated with a higher likelihood of HI in many, but not all, population-based studies, with stronger associations found in studies that included younger age groups. Pathophysiologic studies suggest that persons with diabetes are predisposed to HI in the higher frequencies. Proposed mechanisms underlying the association between diabetes and HI include the combined contributions of hyperglycemia and oxidative stress to cochlear microangiopathy and auditory neuropathy. In this review, we highlight recent population-based studies of type 2 diabetes and HI and examine evidence for diabetes-induced pathophysiologic changes that may result in damage to the auditory system.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

Abbreviations

PTA:

Pure-tone average

HI:

Hearing impairment

kHz:

Kilohertz

dB:

Decibels, expressed as hearing level

ABR:

Auditory brainstem response

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Agrawal Y, Platz EA, Niparko JK. Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999–2004. Arch Intern Med. 2008;168(14):1522–30. doi:10.1001/archinte.168.14.1522.

    Article  PubMed  Google Scholar 

  2. Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. Arch Intern Med. 2011;171(20):1851–2. doi:10.1001/archinternmed.2011.506.

    PubMed Central  Article  PubMed  Google Scholar 

  3. Contrera KJ, Betz J, Genther DJ, Lin FR. Association of Hearing Impairment and Mortality in the National Health and Nutrition Examination Survey. JAMA Otolaryngol Head Neck Surg. 2015;141(10):944–46. doi:10.1001/jamaoto.2015.1762.

  4. Helzner EP. Age related hearing loss. In: Newman AB, Cauley JA, editors. The epidemiology of aging. Dordrecht: Springer; 2012.

    Google Scholar 

  5. Horikawa C, Kodama S, Tanaka S, Fujihara K, Hirasawa R, Yachi Y, et al. Diabetes and risk of hearing impairment in adults: a meta-analysis. J Clin Endocrinol Metab. 2013;98(1):51–8. doi:10.1210/jc.2012-2119. Meta-analysis of thirteen studies, pooling the data of 20,194 individuals, 7,377 of whom had HI based on a pure-tone audiometry. Compared to non-diabetic patients, the odds of HI among diabetic patients were 2.15 (95% CI 1.72–2.68). The association was stronger among adults <60 years compared to those ≥60 years.

    Article  CAS  PubMed  Google Scholar 

  6. Prevention CfDCa. National diabetes statistics report: estimates of diabetes and its burden in the United States. Atlanta: U.S. Department of Health and Human Services; 2014.

    Google Scholar 

  7. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14. doi:10.1001/jama.2014.732.

    Article  CAS  PubMed  Google Scholar 

  8. National Diabetes Data Group NIoDaDaKD. Diabetes in America. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995.

    Google Scholar 

  9. Fukushima H, Cureoglu S, Schachern PA, Paparella MM, Harada T, Oktay MF. Effects of type 2 diabetes mellitus on cochlear structure in humans. Arch Otolaryngol Head Neck Surg. 2006;132(9):934–8. doi:10.1001/archotol.132.9.934. This study of temporal bones from 18 type 2 diabetic patients and 26 age-matched controls found that, compared to controls, diabetic patients demonstrated greater reduction in cochlear hair cells, and thicker vessel walls and greater atrophy of the stria vascularis.

    Article  PubMed  Google Scholar 

  10. Helzner EP, Cauley JA, Pratt SR, Wisniewski SR, Zmuda JM, Talbott EO, et al. Race and sex differences in age-related hearing loss: the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2005;53(12):2119–27. doi:10.1111/j.1532-5415.2005.00525.x.

    Article  PubMed  Google Scholar 

  11. Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149:1–10.

    PubMed Central  Article  PubMed  Google Scholar 

  12. Dalton DS, Cruickshanks KJ, Klein R, Klein BE, Wiley TL. Association of NIDDM and hearing loss. Diabetes Care. 1998;21(9):1540–4.

    Article  CAS  PubMed  Google Scholar 

  13. Mitchell P, Gopinath B, McMahon CM, Rochtchina E, Wang JJ, Boyages SC, et al. Relationship of Type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss. Diabet Med. 2009;26(5):483–8. doi:10.1111/j.1464-5491.2009.02710.x.

    Article  CAS  PubMed  Google Scholar 

  14. Gates GA, Cobb JL, D’Agostino RB, Wolf PA. The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg. 1993;119(2):156–61. doi:10.1001/archotol.1993.01880140038006.

    Article  CAS  PubMed  Google Scholar 

  15. Lin FR, Thorpe R, Gordon-Salant S, Ferrucci L. Hearing loss prevalence and risk factors among older adults in the United States. J Gerontol Ser A Biol Med Sci. 2011;66(5):582–90. doi:10.1093/gerona/glr002.

    Article  Google Scholar 

  16. Cheng YJ, Gregg EW, Saaddine JB, Imperatore G, Zhang X, Albright AL. Three decade change in the prevalence of hearing impairment and its association with diabetes in the United States. Prev Med. 2009;49(5):360–4.

    Article  PubMed  Google Scholar 

  17. Zipf G, Chiaapa M, Porter K, Ostchega Y, Lewis B, Dostal J. The National Health and Nutrition Examination Survey: Plan and Operations, 1999–2010. Vital Health Stat. 2013;1(56): National Center for Health Statistics.

  18. Akinpelu OV, Mujica-Mota M, Daniel SJ. Is type 2 diabetes mellitus associated with alterations in hearing? A systematic review and meta-analysis. Laryngoscope. 2014;124(3):767–76. doi:10.1002/lary.24354. Meta-analysis of six studies (pooled sample of 900 type 2 diabetic patients and 5323 non-diabetic controls). Diabetic patients had 91% higher odds of HI than non-diabetic controls (OR 1.91, 95% CI 1.47–2.49). The association was stronger among adults <65 years compared to those ≥65 years.

    Article  PubMed  Google Scholar 

  19. Szalat A, Raz I. Metabolic syndrome and microangiopathy. Isr Med Assoc J. 2006;8(6):424–5.

    PubMed  Google Scholar 

  20. Guerci B, Kearney-Schwartz A, Bohme P, Zannad F, Drouin P. Endothelial dysfunction and type 2 diabetes. Part 1: physiology and methods for exploring the endothelial function. Diabetes Metab. 2001;27(4 Pt 1):425–34.

    CAS  PubMed  Google Scholar 

  21. Taslipinar A, Yaman H, Yilmaz MI, Demirbas S, Saglam M, Taslipinar MY, et al. The relationship between inflammation, endothelial dysfunction and proteinuria in patients with diabetic nephropathy. Scand J Clin Lab Invest. 2011;71(7):606–12. doi:10.3109/00365513.2011.598944.

    Article  PubMed  Google Scholar 

  22. Falbe-Hansen J. Histochemical studies on glycogen in the cochlea of drug-injected guinea pigs and alloxan-diabetic white rats. Acta Oto-Laryngologica Suppl. 1964; 57, Iss.sup188.

  23. Nakae S, Tachibana M. The cochlea of the spontaneously diabetic mouse. II. Electron microscopic observations of non-obese diabetic mice. Arch Otorhinolaryngol. 1986;243(5):313–6.

    Article  CAS  PubMed  Google Scholar 

  24. Raynor E, Robison WG, Garrett CG, McGuirt WT, Pillsbury HC, Prazma J. Consumption of a high-galactose diet induces diabetic-like changes in the inner ear. Otolaryngol Head Neck Surg. 1995;113(6):748–54.

    Article  CAS  PubMed  Google Scholar 

  25. Makishima K, Tanaka K. Pathological changes of the inner ear and central auditory pathway in diabetic patients. Ann Otol Rhinol Laryngol. 1971;80(2):218–28.

    CAS  PubMed  Google Scholar 

  26. Sonneville R, den Hertog HM, Guiza F, Gunst J, Derese I, Wouters PJ, et al. Impact of hyperglycemia on neuropathological alterations during critical illness. J Clin Endocrinol Metab. 2012;97(6):2113–23. doi:10.1210/jc.2011-2971.

    Article  CAS  PubMed  Google Scholar 

  27. Malone JI, Hanna S, Saporta S, Mervis RF, Park CR, Chong L, et al. Hyperglycemia not hypoglycemia alters neuronal dendrites and impairs spatial memory. Pediatr Diabetes. 2008;9(6):531–9. doi:10.1111/j.1399-5448.2008.00431.x.

    Article  PubMed  Google Scholar 

  28. Hinder LM, Vincent AM, Burant CF, Pennathur S, Feldman EL. Bioenergetics in diabetic neuropathy: what we need to know. J Peripher Nerv Syst. 2012;17 Suppl 2:10–4. doi:10.1111/j.1529-8027.2012.00389.x.

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  29. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001;414(6865):813–20. doi:10.1038/414813a.

    Article  CAS  PubMed  Google Scholar 

  30. Vincent AM, Olzmann JA, Brownlee M, Sivitz WI, Russell JW. Uncoupling proteins prevent glucose-induced neuronal oxidative stress and programmed cell death. Diabetes. 2004;53(3):726–34.

    Article  CAS  PubMed  Google Scholar 

  31. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82(964):95–100. doi:10.1136/pgmj.2005.036137.

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  32. Kavanagh KT, Beardsley JV. Brain stem auditory evoked response. Ann Otol Rhinol Laryngol Suppl. 1979;88(4 Pt 2 Suppl 58):1–28.

    Article  CAS  PubMed  Google Scholar 

  33. Burkard RF, Eggermont JJ, Don M. Auditory evoked potentials: basic principles and clinical application. Philadelphia: Lippincott Williams & Wilkins; 2007.

    Google Scholar 

  34. Vaughan N, James K, McDermott D, Griest S, Fausti S. Auditory brainstem response differences in diabetic and non-diabetic veterans. J Am Acad Audiol. 2007;18(10):863–71.

    Article  PubMed  Google Scholar 

  35. Ernfors P, Van De Water T, Loring J, Jaenisch R. Complementary roles of BDNF and NT-3 in vestibular and auditory development. Neuron. 1995;14(6):1153–64.

    Article  CAS  PubMed  Google Scholar 

  36. Fritzsch B, Silos-Santiago I, Bianchi LM, Farinas I. The role of neurotrophic factors in regulating the development of inner ear innervation. Trends Neurosci. 1997;20(4):159–64.

    Article  CAS  PubMed  Google Scholar 

  37. Krabbe KS, Nielsen AR, Krogh-Madsen R, Plomgaard P, Rasmussen P, Erikstrup C, et al. Brain-derived neurotrophic factor (BDNF) and type 2 diabetes. Diabetologia. 2007;50(2):431–8. doi:10.1007/s00125-006-0537-4.

    Article  CAS  PubMed  Google Scholar 

  38. Huang TJ, Sayers NM, Verkhratsky A, Fernyhough P. Neurotrophin-3 prevents mitochondrial dysfunction in sensory neurons of streptozotocin-diabetic rats. Exp Neurol. 2005;194(1):279–83. doi:10.1016/j.expneurol.2005.03.001.

    Article  CAS  PubMed  Google Scholar 

  39. Jorgensen MB, Buch NH. Studies on inner-ear function and cranial nerves in diabetics. Acta Otolaryngol. 1961;53:350–64.

    Article  CAS  PubMed  Google Scholar 

  40. Gordon-Salant S. Hearing loss and aging: new research findings and clinical implications. J Rehabil Res Dev. 2005;42(4 Suppl 2):9–24.

    Article  PubMed  Google Scholar 

  41. Gratton MA, Schmiedt RA, Schulte BA. Age-related decreases in endocochlear potential are associated with vascular abnormalities in the stria vascularis. Hear Res. 1996;102(1–2):181–90.

    Article  CAS  PubMed  Google Scholar 

  42. Yamasoba T, Lin FR, Someya S, Kashio A, Sakamoto T, Kondo K. Current concepts in age-related hearing loss: epidemiology and mechanistic pathways. Hear Res. 2013;303:30–8. doi:10.1016/j.heares.2013.01.021.

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  43. Vasilyeva ON, Frisina ST, Zhu X, Walton JP, Frisina RD. Interactions of hearing loss and diabetes mellitus in the middle age CBA/CaJ mouse model of presbycusis. Hear Res. 2009;249(1–2):44–53. doi:10.1016/j.heares.2009.01.007.

    PubMed Central  Article  PubMed  Google Scholar 

  44. Yamasoba T, Oka Y, Tsukuda K, Nakamura M, Kaga K. Auditory findings in patients with maternally inherited diabetes and deafness harboring a point mutation in the mitochondrial transfer RNA(Leu) (UUR) gene. Laryngoscope. 1996;106(1 Pt 1):49–53.

    Article  CAS  PubMed  Google Scholar 

  45. Arsenijevic D, Onuma H, Pecqueur C, Raimbault S, Manning BS, Miroux B, et al. Disruption of the uncoupling protein-2 gene in mice reveals a role in immunity and reactive oxygen species production. Nat Genet. 2000;26(4):435–9. doi:10.1038/82565.

    Article  CAS  PubMed  Google Scholar 

  46. Newkirk JE, Taylor RW, Howell N, Bindoff LA, Chinnery PF, Alberti KG, et al. Maternally inherited diabetes and deafness: prevalence in a hospital diabetic population. Diabet Med. 1997;14(6):457–60. doi:10.1002/(SICI)1096-9136(199706)14:6<457::AID-DIA372>3.0.CO;2-W.

    Article  CAS  PubMed  Google Scholar 

  47. Khardori R, Stephens JW, Page OC, Dow RS. Diabetes mellitus and optic atrophy in two siblings: a report on a new association and a review of the literature. Diabetes Care. 1983;6(1):67–70.

    Article  CAS  PubMed  Google Scholar 

  48. Eller P, Foger B, Gander R, Sauper T, Lechleitner M, Finkenstedt G, et al. Wolfram syndrome: a clinical and molecular genetic analysis. J Med Genet. 2001;38(11):E37.

    PubMed Central  Article  CAS  PubMed  Google Scholar 

  49. Mayeda ER, Whitmer RA, Yaffe K. Diabetes and cognition. Clin Geriatr Med. 2015;31(1):101–15. doi:10.1016/j.cger.2014.08.021. ix.

  50. Diabetes Public Health Resource. Health Status and Disability. Centers for Disease Control and Prevention web site. [http://www.cdc.gov/diabetes/statistics/health_status_national.htm]. Last updated October 5, 2012. Accessed 28 Oct 2015.

  51. Diabetes Fast Stats. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/fastats/diabetes.htm Last updated September 29, 2015. Accessed 28 Oct 2015.

Download references

Author information

Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Medical Center, 450 Clarkson Avenue, Mail Stop 43, Brooklyn, NY, 11203, USA

    Elizabeth Purchase Helzner

  2. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kevin J. Contrera

Authors
  1. Elizabeth Purchase Helzner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kevin J. Contrera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Purchase Helzner.

Ethics declarations

Conflict of Interest

Elizabeth Purchase Helzner and Kevin Contrera declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Diabetes Epidemiology

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Helzner, E.P., Contrera, K.J. Type 2 Diabetes and Hearing Impairment. Curr Diab Rep 16, 3 (2016). https://doi.org/10.1007/s11892-015-0696-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11892-015-0696-0

Keywords

  • Diabetes
  • Hearing
  • Epidemiology
  • Presbycusis