A review of 17 studies reports a fourfold increase in risk and ties worse hearing to longer disease duration and higher HbA1c.
People with type 2 diabetes are significantly more likely to have hearing loss than those without the condition, according to a systematic review and meta analysis published in Otolaryngology Head and Neck Surgery.
Across 17 studies involving 3,910 people with diabetes and 4,084 controls, the odds of hearing loss were more than four times higher in the diabetes group.
The analysis, led by researchers at Hospital Clínic and the University of Barcelona, found that hearing loss in diabetes is most evident at higher frequencies.
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On pure tone testing, average thresholds in the diabetes group were 3.19 decibels worse than in controls, with the largest gap at high frequencies.
Duration of disease and glucose control mattered.
People who had lived with diabetes for more than ten years had roughly double the risk of hearing loss compared with those with a shorter duration.
Those with moderate or severe to profound hearing loss had higher average HbA1c levels than controls, pointing to a link between poorer glycaemic control and greater impairment.
The analysis found no difference by sex.
Prevalence estimates varied widely between studies, from about 41 percent to 72 percent among people with type 2 diabetes.
The authors suggest that damage to the tiny blood vessels of the inner ear may be part of the explanation, with structural changes in cochlear capillaries seen in previous research.
What this means for people living with diabetes
Hearing problems are common and often missed until they affect daily life.
The new evidence strengthens the case for making hearing checks part of routine diabetes care, especially for those with long standing diabetes or higher HbA1c levels.
Anyone who notices difficulty following conversations, needs to turn up the television more than before, or experiences persistent ringing in the ears should speak to a GP or audiologist.
Sources: Otolaryngology Head and Neck Surgery meta analysis and accompanying press material from the American Academy of Otolaryngology Head and Neck Surgery.
