The clinical study of audiologic manifestations of type 2 diabetes mellitus in association with other diabetic microvascular complications: an observational study
DOI:
https://doi.org/10.18203/2349-3933.ijam20202581Keywords:
Complications, Diabetes mellitus, Hearing loss, Microvascular, SensorineuralAbstract
Background: Sensorineural hearing loss (SNHL) is a major clinical and public health problem. Diabetes mellitus (DM) is characterized by various microvascular and macrovascular complications. DM is associated with thickening of basal membrane of the stria vascularis capillaries on the lateral wall of cochlea and neuropathic changes which leads to SNHL.
Methods: This is an observational study involving 160 participants grouped into diabetics and non-diabetics. DM was diagnosed using standard American Diabetes Association (ADA) criteria. All the participants were subjected to pure tone audiometry to detect SNHL which was graded into mild, moderate, severe and profound based on degree of decibel loss. The occurrence of SNHL was compared with the occurrence of microvascular complications among diabetics.
Results: In our study, 34 (42.5%) cases and 8 (10%) of controls had SNHL. The occurrence of SNHL was higher among diabetics than non-diabetics (p <0.0001) with majority (88.23%) of cases having bilateral SNHL. Among diabetics, 26 (32.5%) had neuropathy, 23 (28.75%) had retinopathy, 21 (26.25%) had nephropathy. There was no statistically significant relationship between occurrence of SNHL and microvascular complications among diabetics (p=0.8614). The occurrence of SNHL correlated with the levels of HbA1c (p = 0.017). The occurrence of SNHL among diabetics was 42.5% as compared to only 10% among non-diabetics which was statistically significant. The occurrence of SNHL correlated with the levels of HbA1c among diabetics suggesting an association between DM and SNHL (p=0.017).
Conclusions: There was increased occurrence of sensorineural hearing loss among the individuals with diabetes mellitus with significant relationship with the glycaemic index.
References
World Health Organization. Deafness and Hearing Loss 2015. http://www.who.int/mediacentre/factsheets/fs300/en/ Accessed 4 November 2015.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study. Diabetologia. 2011 Dec 1;54(12):3022-7.
Huizinga MM, Rothman RL. Addressing the diabetes pandemic: a comprehensive approach. Indian J Med Res. 2006;124:481-4.
Li TC, Kardia SL, Li CI, Chen CC, Liu CS, Yang SY, et al. Glycemic control paradox: poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes. Metab. 2015;64:1013-21.
Zoungas S, Chalmers J, Ninomiya T, Li Q, Cooper ME, Colagiuri S, et al. Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetol. 2012;55:636-43.
Nakae S, Tachibana M. The cochlea of the spontaneously diabetic mouse. II. Electron microscopic observations of non-obese diabetic mice. Arch Otorhinolaryngol. 1986;243:313-6.
Fukushima H, Cureoglu S, Schachern PA, Kusunoki T, Oktay MF, Fukushima N, et al. Cochlear changes in patients with type 1 diabetes mellitus. Otolaryngol Head Neck Surg. 2005;133:100-6.
Engdahl B, Aarhus L, Lie A, Tambs K. Cardiovascular risk factors and hearing loss: The HUNT study. Int J Audiol. 2015;54:958-66.
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;26:483-8.
Kim MB, Zhang Y, Chang Y, Ryu S, Choi Y, Kwon MJ, et al. Diabetes mellitus and the incidence of hearing loss: a cohort study. Int J Epidemiol. 2017;46(2):727.
Srinivas CV, Shyamala V, Shiva Kumar BR. Clinical Study to Evaluate the Association Between Sensorineural Hearing Loss and Diabetes Mellitus in Poorly Controlled Patients Whose HbA1c >8. Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):191-5.
Rust KR, Prozama JIV, Pillsbury HC. Inner ear damage secondary to diabetes mellitus. Arch Otorhinol Head Neck Surg. 1972;118:397-400.
Bayındır T, Erdem T, Uzer E, Toplu Y, Sarı R, Ozturan O. Evaluation of the auditory effects in controlled and uncontrolled type 2 diabetes mellitus using otoacoustic emissions. J Inonu Univ Med Fac. 2010;17(4):337-41.
Kurien M, Thomas K, Bhanu TS. Hearing threshold in patients with diabetes mellitus. J Laryngol Otol. 1989;103(2):164.
Cruickshanks KJ, Nondahl DM, Dalton DS, Fischer ME, Klein BEK, Klein R, et al. Smoking, central adiposity, and poor glycemic control increase risk of hearing impairment. J Am Geriatr Soc. 2015;63:918-24.
