Type 2 diabetes and hearing loss in personnel of the Self-Defense Forces

High-Frequency Audiovestibular Dysfunction in Long-Standing Diabetes Mellitus: Insights from a Cross-Sectional Study

This study investigates audiovestibular dysfunction in individuals with long-standing diabetes mellitus (DM). A cross-sectional study was conducted involving 100 patients (DM for ≥ 10 years) at the Department of E.N.T. in Prakash Institute of Medical Sciences and Research, Sangli, Maharashtra. A mean age of 43.09 years among patients, with 64% male and 36% female participants. Hearing loss was the most common complaint, affecting 46% of subjects, followed by vertigo in 23%. Pure tone audiometry revealed that 34% of patients had sensorineural hearing loss, with varying degrees of severity. Vestibular dysfunction was observed in 10% of cases. Correlation analysis indicated a significant positive relationship between the duration of DM and hearing thresholds at various frequencies, as well as with HbA1c levels. This suggests a worsening of hearing with longer DM duration and higher HbA1c levels. The prevalence of hearing impairment was higher at higher frequencies, with vestibular dysfunction also noted in a subset of patients.

Prevalence and Associated Factors of Sensorineural Hearing Impairment Among Patients with T2DM in Amhara Region, Northwest Ethiopia, 2022: A Multi-Centered Cross-Sectional Study

Background

Generally, people with type 2 diabetes mellitus in various countries experience a significant rate of sensorineural hearing impairment. Nonetheless, there is scant evidence of sensorineural hearing impairment among type 2 diabetes mellitus patients in Northwest Ethiopian. Therefore, the objective of this study was to evaluate the occurrence rate and contributing factors of sensorineural hearing impairment in type 2 diabetics at comprehensive and specialized referral hospitals in Northwest Ethiopia.

Methods

A facility-based cross-sectional study design was carried out from May 3, 2022, to June 14, 2022, on 846 study participants in Ethiopia, with a response rate of 99.65%. The research subjects were chosen by simple random sampling techniques. Data was gathered by using audiometric measurements and structured interview-administered questionnaires and then entered into EPI data version 4.6. Finally, it was exported to STATA 14 for analysis. Binary logistic regression, chi-square test, and odds ratio were done to verify the assumptions and degree of association. Ultimately, factors exhibiting a p-value < 0.05 with a 95% CI were regarded as significant predictors of hearing impairment.

Results

The magnitude of sensorineural hearing impairment in this investigation was 50.49% (95% CI: 45.67%, 55.26%). Factors significantly associated with sensorineural hearing impairment were age (AOR=1.10, 95% CI: 1.07, 1.14), hyperlipidemia (AOR=2.86, 95% CI: 1.05, 7.82), duration of diabetes (AOR=2.26, 95% CI: 1.26, 4.06), hypertension (AOR=1.94, 95% CI: 1.02, 3.69) and regular physical exercise (AOR=0.25, 95% CI: 0.09, 0.68).

Conclusions and Recommendations

In this study, relatively high rates of sensorineural hearing impairment were observed. Stakeholders should establish routine hearing screening, and participants will advise to incorporate regular physical exercise into their routines.

Relationship of cardiovascular disease risk and hearing loss in a clinical population

Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA_0.5,1,2,4) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated.

Diabetes is a risk factor for hearing loss in older adults: Results of a community screening programme

OBJECTIVES

To investigate the association between diabetes mellitus (DM) and the prevalence and severity of hearing loss in a population of community-dwelling older adults in Singapore.

MATERIALS AND METHODS

This is a retrospective, cross-sectional study of 1787 adults aged 60-100 who had undergone a comprehensive audiological assessment in a community-based audiology clinic. Data extracted included their age, hearing profile, medical history, and comorbidities collected through verbal interview at the point of audiologic assessment. Multivariate linear regression and multivariate logistic regression were performed to investigate the relationship between DM and hearing loss.

RESULTS

The prevalence of DM in our studied population is 17.9%. After controlling for age, gender, race, hypertension, and hyperlipidaemia status, DM was found to be independently associated with at least moderate hearing loss (adjusted OR 1.3 [95% CI 1.06-1.59], p = .012). This was especially so in the younger (<70) age group (adjusted OR 1.7 [95% CI 1.18-2.44], p = .004).

CONCLUSION

DM is an independent risk factor for the presence of at least moderate hearing in community-dwelling seniors. Individuals aged <70 with DM should be screened for hearing loss to enable early intervention.

Interpreting auditory brainstem evoked responses and distortion product otoacoustic emissions in diabetic patients with normal hearing

OBJECTIVE

Hearing impairment is a reported late complication of diabetes mellitus (DM). Previous studies have suggested that microangiopathic complications may cause cochlear nerve function deterioration. We evaluated the auditory brainstem evoked responses (ABRs) and distortion product otoacoustic emission (DPOAE) results according to the presence of DM in subjects with normal hearing.

METHODS

A cross-sectional comparative study was conducted from January 2016 to January 2018. Auditory function tests including ABR and DPOAE were performed for outpatients complaining of unilateral tinnitus. All of analyses were conducted in ears without tinnitus on contralateral side of tinnitus ears. We included subjects showing hearing thresholds within 25 dB at 0.5, 1k, 2k, and 4k on pure tone audiometry. 45 ears in patients with type 2 diabetes mellitus and 85 ears in non-diabetic patients were finally enrolled in our study.

RESULTS

Diabetic subjects showed significantly more prolonged absolute peak latencies (I, III, V) and inter-peak latencies (I-V, III-V) than non-diabetic subjects. However, there was no significant difference in the inter-peak latency (I-III) between these two groups. Diabetic subjects also showed significantly lower amplitudes at f2 frequencies of 1001, 1200, 1587, 4004, 5042, and 6348 Hz than non-diabetic subjects. Additionally, the prevalence of a DPOAE response, defined as 3 dB above the noise floor, was significantly lower in diabetic subjects than that in non-diabetic subjects.

CONCLUSION

Diabetic patients with normal hearing can still have abnormal ABR and DPOAE results due to diabetic neuroangiopathy. ABR and DPOAE assessments can help in detecting subclinical auditory dysfunction, which precedes the manifestation of hearing impairment in diabetic patients.

Association between hypertension, dyslipidemia, and diabetes and prevalence of hearing impairment in Japan

Epidemiological information regarding the relationship between hypertension, dyslipidemia, and/or diabetes and hearing impairment (HI) has been controversial. The present cross-sectional study investigated this issue in Japan. The subjects were 371 men and 639 women aged 36‒84 years. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or current use of antihypertensive medication. Dyslipidemia was defined as a serum low-density lipoprotein cholesterol concentration ≥140 mg/dL, high-density lipoprotein cholesterol concentration <40 mg/dL, triglyceride concentration ≥150 mg/dL, or current use of cholesterol-lowering medication. Diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, hemoglobin A1c level ≥6.5%, or current use of diabetic medication. HI was defined as present when subjects did not respond to a pure-tone average of >25 dB HL in the better hearing ear. Adjustments were made for age, smoking, alcohol consumption, body mass index, household income, and education. The prevalence of HI was 31.5% in men and 20.8% in women. In men, hypertension, but not dyslipidemia or diabetes, was independently positively associated with HI: the adjusted prevalence ratio (PR) was 1.52 (95% CI: 1.07‒2.16). Having at least two cardiovascular risk factors among hypertension, dyslipidemia, and diabetes was independently positively related to HI: the adjusted PR was 1.82 (95% CI: 1.11‒2.99, P for trend = 0.02). Such positive associations were not found in women. Hypertension and having at least two cardiovascular risk factors may be positively associated with HI in men only.

Epidemiology of Diabetes and Hearing Loss

Hearing loss is a highly prevalent chronic condition. In addition to age, sex, noise exposure, and genetic predisposition, cardiovascular disease and its antecedents may precipitate hearing loss. Of emerging interest is the connection between diabetes and auditory dysfunction. Cross-sectional studies consistently suggest that prevalence of hearing loss is higher in persons with diabetes compared with those without diabetes, especially among younger persons. Furthermore, longitudinal studies have demonstrated higher incidence of hearing loss in persons with diabetes compared to those without diabetes. These findings seem to hold for both type 1 and type 2 diabetes, although considerably more population-based evidence is available for type 2 diabetes. Data on gestational diabetes and hearing outcomes are limited, as are data relating diabetes to otologic sequelae such as fungal infection. Here, we examine evidence from epidemiologic studies of diabetes and hearing loss and consider clinical and laboratory data where population-based data are lacking.

Alterations in hearing function of patients with glucose disorders

OBJECTIVE

To study the prevalence of hearing impairment in patients with various glucose disorders.

PATIENTS AND METHODS

A total of 499 individuals were studied, 51 patients with type 1 (TIDM), 188 patients with type 2 diabetes mellitus (T2DM), 39 patients with impaired fasting glucose (IFG), and 221 controls. Measurements were performed, blood was drawn, and a relevant questionnaire was completed. Ηearing function was assessed by pure-tone audiometry (PTA) and distortion product otoacustic emissions (DPOAEs).

RESULTS

Patients with impaired glucose metabolism (IGM: T2DM or IFG) compared to controls had a higher percentage of abnormal PTA and DPOAEs for both the right (70.2 vs. 56.9% and 40.4 vs. 24.2%, respectively, p < 0.001) and the left (74.1 vs. 59.3% and 47.5 vs. 25.4%, respectively, p < 0.001) ear. Patients with TIDM had similar levels for the left ear (54.9 vs. 59.3% and 27.5 vs. 25.4%, respectively, p > 0.05) and lower levels for the right ear (35.3 vs. 56.9% and 13.7 vs. 24.2%, respectively, p < 0.001 and p = 0.044) percentages of abnormal PTA and DPOAEs compared to controls. Logistic regression analysis indicated that independent parameters for abnormal DPOAEs in one or both ears are age, male gender, exposure to noisy environments, and the presence of IGM.

CONCLUSIONS

Hearing impairment was more prevalent in patients with IGM compared to healthy controls, as assessed by PTA and DPOAEs. Age, male gender, and exposure to noise are other factors that can independently affect hearing ability. Physicians should bear in mind possible defects in hearing ability when dealing with such patients.

Genome-wide DNA methylation analysis of human peripheral blood reveals susceptibility loci of diabetes-related hearing loss

Diabetes-related hearing loss (DRHL) is a complication of diabetes mellitus that is drawing more attention currently. DNA methylation has a critical role in the pathogenesis of type 2 diabetes mellitus (T2DM) and its complications. Therefore, we investigated the genome-wide DNA methylation of peripheral blood of T2DM patients with/without hearing loss in order to explore the susceptibility loci of DRHL. Between DRHL group and control group, 113 gene sites were identified to be differentially methylated regions (DMRs). Among 38 DMRs with whole samples, the classification accuracy is up to 90%. With alignment to T2DM susceptibility genes and deafness genes published, KCNJ11 was found to be the only overlapped gene. The DNA methylation level of KCNJ11 was associated with stroke (t = 2.595, p < 0.05), but not with diabetic nephropathy and diabetic retinopathy. The detective rate of distortion product otoacoustic emissions (DPOAE) from low to high frequencies (0.7-6 kHz) on the right ear was significantly correlated with the methylation level of KCNJ11. The auditory brainstem response (ABR) threshold on the right ear was also correlated (r = 0.678, p < 0.05). This DNA methylation profile indicates the susceptibility loci of DRHL. The potassium metabolism may have a critical role in the hearing loss caused by hyperglycemia.

Impairment of extra-high frequency auditory thresholds in subjects with elevated levels of fasting blood glucose

This study was performed to assess whether there is an association between elevated Fasting Blood Glucose (FBG) and hearing impairment in Bangladeshi population. A total of 142 subjects (72 with elevated FBG; 70 control) were included in the study. The mean auditory thresholds of the control subjects at 1, 4, 8 and 12 kHz frequencies were 6.35 ± 0.35, 10.07 ± 0.91, 27.57 ± 1.82, 51.28 ± 3.01 dB SPL (decibel sound pressure level), respectively and that of the subjects with elevated FBG were 8.33 ± 0.66, 14.37 ± 1.14, 38.96 ± 2.23, and 71.11 ± 2.96 dB, respectively. The auditory thresholds of the subjects with elevated FBG were significantly (p < 0.05) higher than the control subjects at all the above frequencies, although hearing impairment was most evidently observed at an extra-high (12 kHz) frequency. Subjects with a long duration of diabetes (>10 years) showed significantly (p < 0.05) higher level of auditory thresholds at 8 and 12 kHz, but not at 1 and 4 kHz frequencies, compared to subjects with shorter duration of diabetes (≤10 years). In addition, based on the data of odds ratio, more acute impairment of hearing at the extra-high frequency was observed in diabetic subjects of both older (>40 years) and younger (≤40 years) age groups compared to the respective controls. The binary logistic regression analysis showed a 5.79-fold increase in the odds of extra-high frequency hearing impairment in diabetic subjects after adjustment for age, gender and BMI. This study provides conclusive evidence that auditory threshold at an extra-high frequency could be a sensitive marker for hearing impairment in diabetic subjects.

Diabetes mellitus and the incidence of hearing loss: a cohort study

Background

To evaluate the association between diabetes mellitus (DM) and the development of incident hearing loss.

Methods

Prospective cohort study was performed in 253 301 adults with normal hearing tests who participated in a regular health-screening exam between 2002 and 2014. The main exposure was the presence of DM at baseline, defined as a fasting serum glucose ≥ 126 mg/dL, a self-reported history of DM or current use of anti-diabetic medications. Pre-diabetes was defined as a fasting glucose 100-125 mg/dL and no history of DM or anti-diabetic medication use. Incident hearing loss was defined as a pure-tone average of thresholds at 0.5, 1.0 and 2.0 kHz > 25 dB in both right and left ears.

Results

During 1 285 704 person-years of follow-up (median follow-up of four years), 2817 participants developed incident hearing loss. The rate of hearing loss in participants with normal glucose levels, pre-diabetes and DM were 1.8, 3.1 and 9.2 per 1000 person-years, respectively ( P < 0.001). The multivariable-adjusted hazard ratios for incident hearing loss for participants with pre-diabetes and DM compared with those with normal glucose levels were 1.04 (95% confidence interval 0.95-1.14) and 1.36 (1.19-1.56), respectively. In spline regression analyses, the risk of incident hearing loss increased progressively with HbA1c levels above 5%.

Conclusions

In this large cohort study of young and middle-aged men and women, DM was associated with the development of bilateral hearing loss. DM patients have a moderately increased risk of future hearing loss.

Early detection of hearing impairment in patients with diabetes mellitus with otoacoustic emission. A systematic review and meta-analysis

CONCLUSIONS

The distortion product otoacoustic emission (DPOAE) amplitudes in diabetics were significantly lower than those in controls when pure tone audiometry (PTA) was within normal limits, implying cochlear function impairment in the early stage of diabetes mellitus. Retrocochlear damage was suggested by elongated wave latencies and the wave interval of auditory brainstem response (ABR) in diabetics.

OBJECTIVES

This study aimed to systematically analyze the application of DPOAE in evaluation of the hearing function of diabetics.

DATA SOURCES AND REVIEW METHODS

Eligible articles were identified through searches of nine different electronic databases. Two investigators reviewed the original articles independently, with pre-defined inclusion and exclusion criteria. Meta-analyses were conducted by using Metan module.

RESULTS

There were seven articles eligible for the analysis. PTA thresholds were within normal limits in all diabetics at low-middle frequencies. The mean DPOAE amplitudes of diabetics were significantly lower than those of controls. The standardized mean difference (SMD) (95% CI) was -0.49 (-0.70, -0.27), -0.46 (-0.63, -0.30), and -0.60 (-0.77, -0.43) at 1, 2, and 4 kHz, respectively. The latencies of waves I, III, and V in diabetes were significantly longer than those of controls (0.43 (0.23, 0.64), 0.54 (0.33, 0.75), and 0.56 (0.35, 0.77), respectively). The wave interval I-V was significantly longer in diabetics (p < .001, 0.47 [0.24, 0.70]).

Risk Factors for Hearing Impairment among Adults with Diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

AIM

The aim was to examine risk factors for hearing impairment among Hispanic/Latino adults with diabetes.

METHODS

Findings are based on 3384 participants aged 18-76 years with diagnosed or previously undetected diabetes who completed audiometric testing as part of the Hispanic Community Health Study/Study of Latinos. We defined hearing impairment as the pure-tone average (PTA) >25 decibels hearing level [dB HL] of pure-tone thresholds at high frequencies (3000, 4000, 6000, and 8000 Hz) in the worse ear and defined a second hearing impairment outcome with the additional requirement of PTA >25 dB HL of low/mid-frequency (500, 1000, and 2000 Hz) thresholds in the worse ear. We identified independent associations using logistic regression.

RESULTS

Controlling for age and Hispanic/Latino background, prevalence ratios for hearing impairment in the high plus low/mid frequencies were 1.35 (95% CI 1.07, 1.71) for current smoking, 1.64 (1.14, 2.38) for alcohol consumption (≥ 14 drinks/week for men or ≥ 7 drinks/week for women), and 1.29 (1.06, 1.56) for triglycerides ≥ 150 mg/dL. For high-frequency only hearing impairment, the prevalence ratio for estimated glomerular filtration rate 30-59 mL/min/1.73m2 was 1.23 (1.03, 1.47) adjusted for age and sex. People with family income less than $20,000 had almost twice the prevalence of hearing impairment (PR=1.93 (1.34, 2.78)) as people with income over $40,000.

CONCLUSIONS

Current smoking, alcohol consumption, high triglycerides, and chronic kidney disease are potentially preventable correlates of hearing impairment for persons with diabetes. Low income is a marker of increased likelihood of hearing impairment.

Association Between Hearing Impairment and Albuminuria in the Korean Adults: The 2011-2012 Korea National Health and Nutrition Examination Survey

Although the associations between albuminuria and renal and cardiovascular diseases, including diabetes and hypertension, have been extensively studied, few studies have investigated the association between albuminuria and hearing impairment. In this study, we assessed the relationship between albuminuria and hearing impairment in 9786 adult Korean subjects, using data from the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2011-2012. The range of urinary albumin-to-creatinine ratio (UACR) was divided into 4 grades: grade 1 (first tertile of low-grade albuminuria [LGA]), 0.00 to 1.99 mg/g Cr; grade 2 (second tertile of LGA), 2.00 to 5.49 mg/g Cr; grade 3 (third tertile of LGA), 5.50 to 29.99 mg/g Cr; grade 4 (albuminuria), ≥30.00 mg/g Cr.The age- and sex-adjusted weighted UACR was higher in subjects with hearing impairment compared with those without hearing impairment (26.2 ± 4.7 mg/g Cr vs 14.1 ± 1.5 mg/g Cr, P = 0.020). The age- and sex-adjusted weighted prevalence of albuminuria was also higher in subjects with hearing impairment compared with subjects without hearing impairment. (8.3 ± 0.9% vs 5.8 ± 0.4%, P = 0.013) The age- and sex-adjusted weighted percentage of hearing impairment increased as UACR increased (18.0% ± 0.6%, 20.0% ± 0.8%, 22.2% ± 0.9%, 25.3% ± 2.0%, respectively; P < 0.001). Logistic regression analyses were performed for hearing impairment by albuminuria, with age, sex, tobacco use, heavy alcohol use, educational background, occupational noise exposure, obesity, hypertension, diabetes, total serum cholesterol, and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m as covariates. Using grade 1 of UACR as the control, grade 3 (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.05-1.53, P = 0.005) and grade 4 (OR 1.41, 95% CI 1.04-1.90, P = 0.026) of UACR were correlated with hearing impairment, respectively. When the level of hearing impairment (dB) was analyzed as a continuous variable, it was positively correlated with log UACR (Spearman correlation, unadjusted r = 0.226, adjusted r = 0.076, P < 0.001).In conclusion, we are the first to demonstrate that albuminuria is associated with hearing impairment in the Korean general population, using nationally representative data. Screening for albuminuria would allow for interventions for the prevention of hearing impairment.

Hearing Impairment in Relation to Severity of Diabetes in a Veteran Cohort

OBJECTIVE

Type 2 diabetes is epidemic among veterans, approaching three times the prevalence of the general population. Diabetes leads to devastating complications of vascular and neurologic malfunction and appears to impair auditory function. Hearing loss prevention is a major health-related initiative in the Veterans Health Administration. Thus, this research sought to identify, and quantify with effect sizes, differences in hearing, speech recognition, and hearing-related quality of life (QOL) measures associated with diabetes and to determine whether well-controlled diabetes diminishes the differences.

DESIGN

The authors examined selected cross-sectional data from the baseline (initial) visit of a longitudinal study of Veterans with and without type 2 diabetes designed to assess the possible differences in age-related trajectories of peripheral and central auditory function between the two groups. In addition, the diabetes group was divided into subgroups on the basis of medical diagnosis of diabetes and current glycated hemoglobin (HbA1c) as a metric of disease severity and control. Outcome measures were pure-tone thresholds, word recognition using sentences presented in noise or time-compressed, and an inventory assessing the self-perceived impact of hearing loss on QOL. Data were analyzed from 130 Veterans ages 24 to 73 (mean 48) years with well-controlled (controlled) diabetes, poorly controlled (uncontrolled) diabetes, prediabetes, and no diabetes. Regression was used to identify any group differences in age, noise exposure history, and other sociodemographic factors, and multiple regression was used to model each outcome variable, adjusting for potential confounders. Results were evaluated in relation to diabetes duration, use of insulin (yes, no), and presence of selected diabetes complications (neuropathy and retinopathy).

RESULTS

Compared with nondiabetics, Veterans with uncontrolled diabetes had significant differences in hearing at speech frequencies, including poorer hearing by 3 to 3.5 dB for thresholds at 250 Hz and in a clinical pure-tone average, respectively. Compared with nondiabetic controls, individuals with uncontrolled diabetes also significantly more frequently reported that their hearing adversely impacted QOL on one of the three subscales (ability to adapt). Despite this, although they also had slightly poorer mean scores on both word recognition tasks performed, these differences did not reach statistical significance and all subjects performed well on these tasks. Compared with Veterans with controlled diabetes, those with uncontrolled disease tended to have had diabetes longer, be insulin-dependent, and have a greater prevalence of diabetic retinopathy. Results are generally comparable with the literature with regard to the magnitude of threshold differences and the prevalence of hearing impairment but extend prior work by providing threshold difference and hearing loss prevalence effect sizes by category of diabetes control and by including additional functional measures.

CONCLUSIONS

In a cohort of Veterans with type 2 diabetes and relatively good hearing, significant effects of disease severity were found for hearing thresholds at a subset of frequencies and for one of the three QOL subscales. Significant differences were concentrated among those with poorly controlled diabetes based on current HbA1c. Results provide evidence that the observed hearing dysfunction in type 2 diabetes might be prevented or delayed through tight metabolic control. Findings need to be corroborated using longitudinal assessments.

Lifelong occupational exposures and hearing loss among elderly Latino Americans aged 65-75 years

OBJECTIVE

The purpose of this study is to determine the relationship between occupational exposures and hearing among elderly Latino Americans.

DESIGN

A descriptive, correlational design used for this secondary analysis with the data from the Sacramento Area Latino Study of Aging (SALSA).

STUDY SAMPLE

A total of 547 older adults were included.

RESULTS

A majority of participants (58%) reported occupational exposures to loud noise and/or ototoxic chemicals. About 65% and over 90% showed hearing loss at low and high frequencies, respectively. Participants with occupational exposure to loud noise and/or ototoxic chemicals were, significantly, two times more likely to have hearing loss at high frequencies compared to those without exposure (OR = 2.29; 95% CI: 1.17 = 4.51, p = .016), after controlling for other risk factors of hearing loss such as age, gender, household income, current smoking, and diabetes. However, lifelong occupational exposure was not significantly associated with hearing loss at low frequencies (OR = 1.43; 95% CI: 0.94 = 2.18, p = .094).

CONCLUSION

Lifelong occupational exposure to loud noise and/or ototoxic chemicals was significantly associated with hearing loss among elderly Latino Americans. Healthy work life through protection from harmful auditory effects of occupational exposures to noise and chemicals will have a positive impact on better hearing in later life.

Severity of hearing impairment is positively associated with urine albumin excretion rate in patients with type 2 diabetes

Aims/Introduction

To identify risk factors for hearing impairment among patients with type 2 diabetes mellitus.

Methods and Materials

A total of 68 patients with type 2 diabetes were enrolled between March and September of 2011. Pure-tone auditory tests were carried out for each patient at the following speech frequencies: 250; 500; 1,000; 2,000; 4,000 and 8,000 Hz. Participants were classified as having hearing impairment if the average of the pure-tone thresholds measured at 500, 1000 and 2000 Hz in either ear exceeded 25 dBHL. Demographic, anthropometric, clinical, and laboratory parameters and diabetes-associated complications were analyzed.

Results

Patients were divided into those with (n = 32) and without (n = 36) hearing impairment. Hearing impaired participants had a higher urine albumin-to-creatinine ratio than those without (223.1 vs 56.5 mg/g, respectively). After adjustment for age, sex and other risk factors, the urine albumin-to-creatinine ratio remained significantly associated with hearing impairment (odds ratio 9.07, 95% confidence interval 1.73–47.43, P = 0.009). There were no significant differences in oxidative stress between the two groups.

Conclusions

The present study showed increased albuminuria was positively associated with the severity of hearing impairment among patients with type 2 diabetes. Screening for hearing impairment in diabetic patients who develop albuminuria might provide early detection of hearing impairment.

Risk factors for hearing impairment among U.S. adults with diabetes: National Health and Nutrition Examination Survey 1999-2004

OBJECTIVE

The objective of this study was to examine the risk factors of low/mid-frequency and high-frequency hearing impairment among a nationally representative sample of diabetic adults.

RESEARCH DESIGN AND METHODS

Data came from 536 participants, aged 20-69 years, with diagnosed or undiagnosed diabetes who completed audiometric testing during 1999-2004 in the National Health and Nutrition Examination Survey (NHANES). We defined hearing impairment as the pure-tone average>25 dB hearing level of pure-tone thresholds at low/mid-frequencies (500; 1,000; and 2,000 Hz) and high frequencies (3,000; 4,000; 6,000; and 8,000 Hz) and identified independent risk factors using logistic regression.

RESULTS

Controlling for age, race/ethnicity, and marital status, odds ratios for associations with low/mid-frequency hearing impairment were 2.20 (95% CI 1.28-3.79) for HDL<40 mg/dL and 3.55 (1.57-8.03) for poor health. Controlling for age, race/ethnicity, sex, and income-to-poverty ratio, odds ratios for associations with high-frequency hearing impairment were 4.39 (1.26-15.26) for history of coronary heart disease and 4.42 (1.26-15.45) for peripheral neuropathy.

CONCLUSIONS

Low HDL, coronary heart disease, peripheral neuropathy, and having poor health are potentially preventable correlates of hearing impairment for people with diabetes. Glycemic control, years since diagnosis, and type of glycemic medication were not associated with hearing impairment.

Three decade change in the prevalence of hearing impairment and its association with diabetes in the United States

OBJECTIVE

To examine the secular change of the prevalence of hearing impairment over three decades in U.S. adults with and without diabetes.

METHODS

The cross-sectional National Health and Nutrition Examination Surveys (NHANES, the 1971-1973 [NHANES I] and the 1999-2004 [NHANES 1999-2004]) were used. Average pure-tone audiometry thresholds in decibels (dB) at 1, 2, 3, and 4 kHz frequencies of the worse ear were used to represent the participants' hearing status. Any hearing impairment was defined as average pure-tone audiometry threshold of the worse ear >25 dB.

RESULTS

From 1971 to 2004, among adults without diabetes aged 25 to 69 years, the unadjusted prevalence of hearing impairment decreased from 27.9% to 19.1% (P<0.001), but among adults with diabetes there was no significant change (46.4% to 48.5%). After adjustment for age, sex, race, and education, the prevalence of hearing impairment in the NHANES I and NHANES 1999-2004, respectively, was 24.4% (95% confidence interval [CI], 22.3-26.6%) and 22.3% (95% CI, 20.4-24.2) for adults without diabetes and 28.5% (95% CI, 20.4-36.6%) and 34.4 (95% CI, 29.1-39.7%) for adults with diabetes. The adjusted prevalence ratios of hearing impairment for persons with diabetes vs. those without diabetes was 1.17 (95% CI, 0.87-1.57) for the NHANES I and 1.53 (95% CI, 1.28-1.83) for NHANES 1999-2004.

CONCLUSIONS

Persons with diabetes have a higher prevalence of hearing impairment, and they have not achieved the same reductions in hearing impairment over time as have persons without diabetes.

Hearing Loss in Patients with Diabetes Mellitus

The relationship between diabetes mellitus and hearing loss is described as ‘controversial’ in the literature, given that in the clinical realm many patients present dysacusis while others do not.

Aim

this study aims to investigate the relationship between hearing loss and diabetes mellitus and add to the knowledge being developed in this area.

Study design

cross-sectional clinical trial.

Materials and method

in our study we analyzed the medical charts of 50 adult patients of both genders, aged above 45 years, and diagnosed with diabetes mellitus, seen in our institution in 2006 and 2007, and compared them to the charts of 50 metabolic disease-free individuals.

Results

this study found statistically significant worse audiometric thresholds among patients with diabetes mellitus when compared to patients in the control group.

Conclusion

the results identified in this study point to a correlation between hearing loss and diabetes mellitus. This possibility should therefore be further investigated by health care workers providing care to patients with diabetes mellitus, in the form of closer follow-up on the auditory health of this patient group.

Interactions of hearing loss and diabetes mellitus in the middle age CBA/CaJ mouse model of presbycusis

Recently, we characterized the more severe nature of hearing loss in aged Type 2 diabetic human subjects [Frisina, S.T., Mapes, F., Kim, S., Frisina, D.R., Frisina, R.D., 2006. Characterization of hearing loss in aged type II diabetics. Hear. Res. 211, 103-113]. The current study prospectively assessed hearing abilities in middle age CBA/CaJ mice with Type 1 diabetes mellitus (T1DM) (STZ injection) or Type 2 diabetes mellitus (T2DM) (high fat diet), for a period of 6 months. Blood glucose, body weight and auditory tests (Auditory Brainstem Response-ABR, Distortion Product Otoacoustic Emissions-DPOAE) were evaluated at baseline and every 2 months. Tone and broad-band noise-burst responses in the inferior colliculus were obtained at 6 months. Body weights of controls did not change over 6 months (approximately 32 g), but there was a significant (approximately 5 g) decline in the T1DM, while T2DM exhibited approximately 10 g weight gain. Blood glucose levels significantly increased: 3-fold for T1DM, 1.3-fold for T2DM; with no significant changes in controls. ABR threshold elevations were found for both types of diabetes, but were most pronounced in the T2DM, starting as early as 2 months after induction of diabetes. A decline of mean DPOAE amplitudes was observed in both diabetic groups at high frequencies, and for the T2DM at low frequencies. In contrast to ABR thresholds, tone and noise thresholds in the inferior colliculus were lower for both diabetic groups. Induction of diabetes in middle-aged CBA/CaJ mice promotes amplification of age-related peripheral hearing loss which makes it a suitable model for studying the interaction of age-related hearing loss and diabetes. On the other hand, initial results of effects from very high blood glucose level (T1DM) on the auditory midbrain showed disruption of central inhibition, increased response synchrony or enhanced excitation in the inferior colliculus.

Early sensorineural hearing loss in ob/ob mouse, an animal model of type 2 diabetes

Objectives

There have been many studies on the relationship between diabetes mellitus and presbycusis. Microangiopathy and neuropathy that's caused by chronic hyperglycemia may lead to damage to the inner ear. Several clinical studies on humans and animal studies have been performed to investigate the association between diabetes and hearing loss, however, this relationship is still a matter of debate. We investigated the association of diabetes and sensorineural hearing loss in an animal model of type-2 diabetes and obesity (the ob/ob mouse [OM]).

Methods

The auditory brainstem response (ABR) thresholds were obtained in the OM and the wild type mice (C57BL/6J mice) up to 25 weeks after birth. After the animals were sacrificed, their cochleae were retrieved and then subjected to histopathologic observations.

Results

The OM exhibited significantly elevated ABR thresholds at 21 weeks of age, yet the C57BL/6J mice exhibited no significant change until 25 weeks of age. On the histological findings, outer hair cell degeneration and loss of spiral ganglion cells were observed in the middle and basal turns of the OM. On the contrary, no degenerative change was observed until 25 weeks of age in the C57BL/6J mice.

Conclusion

This study suggests that chronic hyperglycemia and obesity may lead to early sensorineural hearing loss.