Association between hearing organ and renal function in young adult type 1 diabetic patients: A cross-sectional study

To Evaluate the Impact of Uncontrolled HbA1C Levels on Hearing in Patients of Type 1 Diabetes Mellitus

To study the prevalence of SNHL in type 1 diabetes mellitus with uncontrolled HbA1c. Prospective study. 72 patients in the age group < 18 yrs were taken for study, who were diagnosed with type 1 diabetes mellitus in department of medicine, paediatrics and endocrinology and willing to undergo ENT examination. The patients with type 2 diabetes mellitus, a history of ear disease, head or ear trauma, history of use of ototoxic drugs, with family history of congenital deafness or previously operated ear and exposure to excessive noise were excluded. A complete ENT examination was done. Written consent was taken from the parents. A note was made of the HbA1c values of the patient of last 1 year in order to classify them as controlled diabetics with regular insulin therapy and uncontrolled diabetics with irregular insulin therapy. The cut off value of HbA1c was taken as 7%. On the basis is glycemic control, the patients were divided in 2 categories, controlled (HbA1C less than 7%) and uncontrolled (HbA1C greater than 7%). The type, degree and frequency of hearing impairement were determined by pure tone audiometry (PTA) (at 500, 1000, 2000 and 4000 Hz).The degree of hearing impairement was classified according to the WHO classification. 72 patients who had type 1 diabetes mellitus were evaluated using pure tone audiometry for hearing assessment. The factors taken into consideration for studying the impact on hearing loss was gender of the patients and HbA1c value. A P value of > 0.05 was seen in case of gender of the patients and a P value of < 0.05 was seen in regard to HbA1c value. Type 1 diabetes mellitus patients with deranged HbA1c and uncontrolled diabetes have higher incidence of hearing loss as compared to the Type 1 diabetes mellitus patients with controlled disease. Therefore if patients have a controlled sugar levels with regular HbA1C monitoring, this can have a preventive action on the SNHL as compared to the patients with uncontrolled HbA1C.

A systematic review of the association of Type I diabetes with sensorineural hearing loss

OBJECTIVES

Type 1 diabetes (T1D) has been associated with several comorbidities such as ocular, renal, and cardiovascular complications. However, the effect of T1D on the auditory system and sensorineural hearing loss (SNHL) is still not clear. The aim of this study was to conduct a systematic review to evaluate whether T1D is associated with hearing impairment.

METHODS

The databases PubMed, Science Direct, Scopus, and EMBASE were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Three reviewers independently screened, selected, and extracted data. The Joanna Briggs Institute (JBI) Critical Appraisal Tools for Analytical cross-sectional and case-control studies were used to perform quality assessment and risk of bias analysis on eligible studies.

RESULTS

After screening a total of 463 studies, 11 eligible original articles were included in the review to analyze the effects of T1D on the auditory system. The included studies comprised cross-sectional and case-control investigations. A total of 5,792 patients were evaluated across the 11 articles included. The majority of the studies showed that T1D was associated with hearing impairment compared to controls, including differences in PTAs and OAEs, increased mean hearing thresholds, altered acoustic reflex thresholds, and problems with the medial olivocochlear (MOC) reflex inhibitory effect. Significant risk factors included older age, increased disease duration, and higher HbA1C levels.

CONCLUSIONS

This systematic review suggests that there is a correlation between T1D and impairment on the auditory system. A multidisciplinary collaboration between endocrinologists, otolaryngologists, and audiologists will lead to early detection of hearing impairment in people with T1D resulting in early intervention and better clinical outcomes in pursuit of improving the quality of life of affected individuals.

REGISTRATION

This systematic review is registered in PROSPERO (CRD42023438576).

Correlation between hearing impairment and the Triglyceride Glucose Index: based on a national cross-sectional study

Objective

Data from the National Health and Nutrition Examination Survey (NHANES) were used to assess the association between the triglyceride-glucose (TyG) index and hearing impairment (HI).

Methods

We used eight survey cycles from NHANES 2001-2012 and 2015-2018 to conduct this cross-sectional study. HI was designed as an dependent variable, and the TyG index was selected as an exposure factor (independent variable). The correlation between the two variables was assessed using multiple logistic regression. In order to assess whether there was a non-linear relationship between the TyG index and HI, the TyG index was distributed and a test for trend was conducted (P for trend), followed by smooth curve fitting (penalized spline) and generalized additive model (GAM) regression. We also performed a subgroup analysis to identify sensitive groups whose responses were clearly associated with independent variables.

Results

10,906 participants were finally included in the study, and those with a higher TyG index had a higher frequency of hearing impairment. There was a linear positive correlation between the TyG index and HI. For the low-frequency HI, however, this positive correlation was not statistically significant (OR = 1.05, 95% CI: 0.98, 1.14); however, it was more stable for the high-frequency HI (OR = 1.12, 95% CI: 1.03, 1.22). Additionally, as the TyG index increased, this positive association increased as well (P for trend = 0.05). The HPTA test showed a positive association with more severe HI (simultaneous) as the independent variable increased (OR = 1.14, 95% CI: 1.05-1.24), and this association was even more significant with increasing severity (P for trend 0.05). According to the subgroup analysis, the positive association between TyG index and high-frequency HI was more significant in females, 40-69 years old, without hypertension or diabetes, and when strict high-frequency HI was significant in males, females, 40-69 years old, with hypertension and diabetes.

Conclusion

Participants with a higher TyG index may have a higher risk of HI. TyG index and HI risk showed a linear relationship, which became even more significant when HPTA was included.