It is estimated that 7% of adults in South Africa have diabetes- this calculates to approximately 3.85 million people. Diabetes has been known to cause many side effects which can often be devastating and sometimes even life threatening- in fact, diabetes is now our second leading cause of death. Despite this severity, many of the effects are not commonly known, and among these are hearing loss, specifically high frequency sensorineural hearing loss.
How can a metabolic disease like diabetes affect the ears? Diabetes causes the body to create abnormal amounts of keratin, which upsets the pH balance and natural bacterial activity of the ear canal. This causes abnormal sensitivity to foreign materials, leading to increased irritation and infection. It can also cause recruitment, which is a distortion of loud sounds. Many diabetics have poor speech understanding, especially in noisy environments, and occasionally hearing loss can even be fluctuating. Diabetes can also cause or compound tinnitus and balance problems.
So why is it important for an Audiologist to know if our patient is diabetic? When recommending hearing aids for a patient there are many variables to consider, including the material used to build the hearing aid, and the size in the ear. Often an ENT consultation is required to assess the sensitivity of the ear canal, so that the right material and fit can be selected. The Audiologist would also need to consider fairly high end technology in the hearing aid, to be able to compress the loud sounds to prevent distortion in the ear. Where the hearing is fluctuating, the person may find a volume control or program button, or a remote control or Smartphone App helpful. The person may require more regular than normal adjustments of the hearing aid. Don’t forget that regular retesting of the hearing is vital- for people at risk for hearing changes, such as those with diabetes, annual hearing testing is recommended.
It is extremely important to be aware of one’s diabetes status, as well as to share this information with your audiologist. Knowing about the condition and it’s challenges will allow the audiologist to make an informed recommendation of the right type of hearing aid for the person’s needs, and to counsel the patient on realistic goals and expectations.
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