International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

Current Issues
     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Association Between Type 2 Diabetes Mellitus and Sensorineural Hearing Loss: A Case-Control Study at Al-Hussein Teaching Hospital, Samawa, Al Muthanna Province

Muhannd Kadhem Madhlom Al-Dhaleme

Al Muthanna health directorate, Al Muthanna, Iraq

Article Information

Volume / Issue4 / 4 (October-December 2023)
Pages92-100
AccessOpen Access

Publication Timeline

  • Received22 August 2023
  • Accepted24 September 2023
  • Published

Full Text (PDF)

Open Access - Free to Download

Download Full Article (PDF) JATS XML

Abstract

Background: Type 2 diabetes mellitus (T2DM) is growing rapidly around the world and has increasingly been identified as a risk factor for sensorineural hearing loss (SNHL). However, despite considerable growing evidence worldwide, only limited studies have been conducted on this association in the general population of Iraq. 
Aims: To determine the prevalence of SNHL in patients with T2DM compared with non-diabetic controls and differentiate the clinical and metabolic characteristics of patients having SNHL compared to those without. 
Methods: We performed a case-control study at Al-Hussein Teaching Hospital in Samawa, Al-Muthanna Governorate, Iraq, from January 2020 until December 2022. Two hundred and forty total participants (120 with T2DM and 120 control participants who were age- and sex-matched) were enrolled. Each participant underwent standard tests such as pure-tone audiometry, tympanometry, and speech discrimination testing to determine hearing loss. Also, we obtained fasting blood glucose values, glycated hemoglobin (HbA1c), lipid profile, and renal function tests to evaluate metabolic and clinical factors. We performed analyses using chi-square, Pearson’s correlation coefficient, and Cox regression analysis. 
Results: Of the diabetic participants, 74 were determined to have SNHL compared to the control participants (p < 0.001, odds ratio [OR]=7.08; 95% confidence interval [CI]: 3.92–12.78). High frequency (4-8 kHz) SNHL was the most common type of hearing loss present in 68 of the diabetic patients (56.7%). In the diabetic cohort, >10 year duration of T2DM (OR=6.30, p<0.001), HbA1c levels ≥ 9.0% (OR=4.31, p<0.001), and age ≥55 years (OR=3.56; p=0.002) were independent risk factors for developing SNHL, as well as hypertension (OR=2.75, p=0.019). Furthermore, the severity of SNHL was moderately correlated with the duration of diabetes (r=0.61; p<0.001) and HbA1c level (r=0.52; p<0.001). 
Conclusion: This study demonstrates the significant association of T2DM and SNHL in the general population of Iraq, with the high frequency of hearing loss being the most commonly found audiological manifestation of the association. Our data suggest that poor glycemic control and prolonged presence of T2DM are the two most significant modifiable risk factors for developing SNHL. It is critical that standard diabetic care providers include routine audiologic evaluation as a component of diabetic screening in Iraq.
 

Keywords

Type 2 diabetes mellitussensorineural hearing losspure-tone audiometryglycaemic controlHbA1cIraqAl-Muthanna

References

  1. International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels: International Diabetes Federation; 2019. [Google Scholar][Crossref]
  2. Mansour AA, Wanoose HL, Hani I, Abed-Al-Abbas B, Saleh MS. Diabetes mellitus screening in Basrah, Iraq: a population-based cross-sectional study. Diabetes Res Clin Pract. 2008;79(1):147-150. [Google Scholar][Crossref]
  3. Motlagh ME, Kelishadi R, Shafiee G, Ardalan G, Taheri M, Zarei M, et al. Prevalence of type 2 diabetes mellitus and impaired fasting glucose in the Middle East and North Africa: a systematic review and meta-analysis. East Mediterr Health J. 2016;22(3):152-167. [Google Scholar][Crossref]
  4. Al-Rubeaan K, Al-Manaa HA, Khoja TA, Ahmad NA, Al-Sharqawi AH, Siddiqui K, et al. Epidemiology of abnormal glucose metabolism in a country facing its epidemic: SAUDI-DM study. J Diabetes. 2015;7(5):622-632. [Google Scholar][Crossref]
  5. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-1625. [Google Scholar][Crossref]
  6. Stach BA. Clinical Audiology: An Introduction. 3rd ed. San Diego: Plural Publishing; 2017. [Google Scholar][Crossref]
  7. World Health Organization. World Report on Hearing. Geneva: World Health Organization; 2021. [Google Scholar][Crossref]
  8. Makishima K. Arteriolar sclerosis as a cause of presbycusis. Otolaryngology. 1978;86(2):322-326. [Google Scholar][Crossref]
  9. Fukushima H, Cureoglu S, Schachern PA, Paparella MM, Harada T, Oktay MF. Effects of type 2 diabetes mellitus on cochlear structure in humans. Arch Otolaryngol Head Neck Surg. 2006;132(9):934-938. [Google Scholar][Crossref]
  10. Frisina ST, Mapes F, Kim S, Frisina DR, Frisina RD. Characterization of hearing loss in aged type II diabetics. Hear Res. 2006;211(1-2):103-113. [Google Scholar][Crossref]
  11. Raynor EM, Carrasco VN, Mulroy MJ, Merchant SN. An immunohistochemical analysis of age-related changes and variability in the vasculature of the normal human cochlea. Otolaryngol Head Neck Surg. 1998;118(5):681-688. [Google Scholar][Crossref]
  12. Gratton MA, Wright CG. Alterations in the cochlear lateral wall vasculature in relation to presbycusis. In: Willott JF, editor. Handbook of Mouse Auditory Research. Boca Raton: CRC Press; 2001. p. 209-226. [Google Scholar][Crossref]
  13. Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and International Journal of Medical and All Body Health Research www.allmedicaljournal.com hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149(1):1-10. [Google Scholar][Crossref]
  14. Sung JH, Cho EH, Jung JY, Park SH, Kim SH, Lee SR, et al. Association between diabetes mellitus and hearing impairment in South Korea. Diabet Med. 2013;30(10):e315-e319. [Google Scholar][Crossref]
  15. Diniz TH, Guida HL. Hearing loss in patients with diabetes mellitus. Braz J Otorhinolaryngol. 2009;75(4):573-578. [Google Scholar][Crossref]
  16. Austin DF, Jones RO, Deal JA, Sharrett AR. Hearing and diabetes in the ARIC cohort: associations and mechanisms. Ear Hear. 2009;30(5):513-521. [Google Scholar][Crossref]
  17. Sone M, Schachern PA, Paparella MM. Loss of spiral ganglion cells as primary man ifestation of aminoglycoside ototoxicity. Hear Res. 1998;115(1-2):217-223. [Google Scholar][Crossref]
  18. Ferreira JJ, Bhatt DL, Schwartz M, Maeder M. Glycemic control and hearing loss: data from a multiethnic population. Diabetes Care. 2013;36(9):2607-2612. [Google Scholar][Crossref]
  19. Mozaffari M, Abdollahinia M, Amini M, Karimian SM. Relationship between the duration of type 2 diabetes mellitus and the severity of hearing loss: a systematic investigation. Iran J Otorhinolaryngol. 2011;23(65):113-120. [Google Scholar][Crossref]
  20. Cruickshanks KJ, Nondahl DM, Tweed TS, Wiley TL, Klein BE, Klein R, et al. Education, occupation, noise exposure history and the 10-yr cumulative incidence of hearing impairment in older adults. Hear Res. 2010;264(1-2):3-9. [Google Scholar][Crossref]
  21. Agrawal Y, Platz EA, Niparko JK. Risk factors for hearing loss in US adults: data from the National Health and Nutrition Examination Survey, 1999 to 2002. Otol Neurotol. 2009;30(2):139-145. [Google Scholar][Crossref]
  22. Saadati HM, Moradi A, Hassanzadeh N. Comparison of sensorineural hearing loss in type 2 diabetic and non-diabetic patients. Iran J Otorhinolaryngol. 2014;26(75):87-90. [Google Scholar][Crossref]
  23. Harner SG. Hearing in adult-onset diabetes mellitus. Otolaryngol Head Neck Surg. 1981;89(2):322-327. [Google Scholar][Crossref]
  24. Horikawa C, Kodama S, Tanaka S, Fujihara K, Hirasawa R, Yachi Y, et al. Diabetes and risk of hearing impairment in adults: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98(1):51-58. [Google Scholar][Crossref]
  25. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Clinical Practice Guideline: Hearing Loss in Adults. Otolaryngol Head Neck Surg. 2019;161(2 Suppl):S1-S57. [Google Scholar][Crossref]
  26. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. [Google Scholar][Crossref]
  27. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Suppl 1):S13-S28. [Google Scholar][Crossref]
  28. Sifuentes-Franco S, Pacheco-Moisés FP, Rodríguez-Carrizalez AD, Miranda-Díaz AG. The role of oxidative stress, mitochondrial function, and autophagy in diabetic polyneuropathy. J Diabetes Res. 2017;2017:1673081. [Google Scholar][Crossref]
  29. National Cholesterol Education Program (NCEP) Expert Panel. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-3421. [Google Scholar][Crossref]
  30. World Health Organization. Prevention of blindness and deafness: grades of hearing impairment [Internet]. Geneva: World Health Organization; 2021 [updated 2021; cited 2022 Jan 1 0] . Available from: https://www.who.int/pbd/deafness/hearing_impairment _grades/en/ [Google Scholar][Crossref]
  31. Field A. Discovering Statistics Using IBM SPSS Statistics. 5th ed. London: SAGE Publications; 2018. [Google Scholar][Crossref]
  32. Abdel Rasoul GM, El-Bahnasawy MM, Ali YM, Taha AM. Hearing impairment in type 2 diabetic patients. J Egypt Public Health Assoc. 2014;89(3):110-116. [Google Scholar][Crossref]
  33. Kakarlapudi V, Sawyer R, Staecker H. The effect of diabetes on sensorineural hearing loss. Otol Neurotol. 2003;24(3):382-386. [Google Scholar][Crossref]
  34. Gates GA, Mills JH. Presbycusis. Lancet. 2005;366(9491):1111-1120. [Google Scholar][Crossref]
  35. Gates GA, Cobb JL, D'Agostino RB, Wolf PA. The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg. 1993;119(2):156-161. [Google Scholar][Crossref]
  36. Abdel Rasoul GM, Sallam SA, Taha AM. Bilateral sensorineural hearing loss in type 2 diabetes: relationship to glycaemic control and disease duration. J Community Health. 2011;36(4):618-624. [Google Scholar][Crossref]
  37. Thakkar B, Sagar MK, Singh S, Sinha M. Audiological patterns in type II diabetes patients: a cross-sectional study. Indian J Otolaryngol Head Neck Surg. 2013;65(4):320-324. [Google Scholar][Crossref]
  38. Khoza-Shangase K, Moroe N. Audiology and diabetes: exploring the current status of audiological screening protocols from a developing country context. Diabetes Res Clin Pract. 2018;139:34-42. [Google Scholar][Crossref]
  39. Tamim H, Alameddine M, Musharrafieh U, Farah S, Awar M. Hearing impairment among diabetics in a developing country: a case-control study. Ann Saudi Med. 2008;28(2):97-101. [Google Scholar][Crossref]
  40. Wackym PA, Linthicum FH Jr. Diabetes mellitus and hearing loss: clinical and histopathological relationships. Am J Otol. 1986;7(3):176-182. [Google Scholar][Crossref]

How to Cite

Al-Dhaleme, M. K. M. (2023). Association Between Type 2 Diabetes Mellitus and Sensorineural Hearing Loss: A Case-Control Study at Al-Hussein Teaching Hospital, Samawa, Al Muthanna Province. International Journal of Medical and All Body Health Research, 4(4), 92-100. https://doi.org/10.54660/IJMBHR.2023.4.4.92-100

Al-Dhaleme, Muhannd Kadhem Madhlom. "Association Between Type 2 Diabetes Mellitus and Sensorineural Hearing Loss: A Case-Control Study at Al-Hussein Teaching Hospital, Samawa, Al Muthanna Province." International Journal of Medical and All Body Health Research, vol. 4, no. 4, 2023, pp. 92-100. https://doi.org/10.54660/IJMBHR.2023.4.4.92-100.

Al-Dhaleme, M. K. M. (2023) 'Association Between Type 2 Diabetes Mellitus and Sensorineural Hearing Loss: A Case-Control Study at Al-Hussein Teaching Hospital, Samawa, Al Muthanna Province', International Journal of Medical and All Body Health Research, 4(4), pp. 92-100. doi: 10.54660/IJMBHR.2023.4.4.92-100.

Al-Dhaleme MKM. Association Between Type 2 Diabetes Mellitus and Sensorineural Hearing Loss: A Case-Control Study at Al-Hussein Teaching Hospital, Samawa, Al Muthanna Province. International Journal of Medical and All Body Health Research. 2023;4(4):92-100. doi:10.54660/IJMBHR.2023.4.4.92-100

Similar Articles

Share

Find this Article on

Google Scholar Semantic Scholar OpenAlex Scilit Crossref ResearchGate BASE

A newly published article may take a few days to appear on these services.