The Annals lead article reports on a newly identified association between diabetes and hearing impairment. We know that hearing loss is common, and we also know that diabetes is common. The question is whether there is an association. Only one previous study addressed a potential association and notably excluded patients younger than 48.
The current study, a cross-sectional analysis, used data from NHANES (National Health and Nutrition Examination Survey) from 1999-2004. In all, 11, 405 people aged 20-69 (which becomes an important point) were studied and about half of them were randomized to audiometric testing. As pointed out in the accompanying editorial, the degree of hearing loss measured in clinical terms is that which would be difficult to detect without formal testing, but which would likely affect an individual’s ability to communicate. Both low-mid frequency and high frequency losses were looked at and in both subsets, diabetes was associated with a greater likelihood of hearing loss. The odds ratio in the low-mid frequency loss was 1.82 and the odds ratio in the high frequency category was 2.16. Age of the population included in this study is important because it may be that diabetes contributes most heavily to younger people. Once the usual risks for developing hearing loss (male sex, lower education, industrial or military occupation, leisure time noise and smoking) were accounted for, diabetes became less of a risk factor. Though controversial, the suggested pathophysiologic mecahanism for hearing loss in diabetes is microvascular damage to the cochlea. Since hearing loss is so difficult to avoid or treat, maybe someday soon we will we be adding audiometric screening to our health maintenance recommendations for our diabetics.
The current study, a cross-sectional analysis, used data from NHANES (National Health and Nutrition Examination Survey) from 1999-2004. In all, 11, 405 people aged 20-69 (which becomes an important point) were studied and about half of them were randomized to audiometric testing. As pointed out in the accompanying editorial, the degree of hearing loss measured in clinical terms is that which would be difficult to detect without formal testing, but which would likely affect an individual’s ability to communicate. Both low-mid frequency and high frequency losses were looked at and in both subsets, diabetes was associated with a greater likelihood of hearing loss. The odds ratio in the low-mid frequency loss was 1.82 and the odds ratio in the high frequency category was 2.16. Age of the population included in this study is important because it may be that diabetes contributes most heavily to younger people. Once the usual risks for developing hearing loss (male sex, lower education, industrial or military occupation, leisure time noise and smoking) were accounted for, diabetes became less of a risk factor. Though controversial, the suggested pathophysiologic mecahanism for hearing loss in diabetes is microvascular damage to the cochlea. Since hearing loss is so difficult to avoid or treat, maybe someday soon we will we be adding audiometric screening to our health maintenance recommendations for our diabetics.
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