Diabetes and Hearing Loss: The Overlooked Complication You Should Know About
Diabetes can affect many parts of the body.
Most people living with diabetes have probably heard about the importance of protecting their eyes, kidneys, heart, nerves, and feet. But there is another part of your health that may receive much less attention:
- Your hearing.
Research has found that hearing impairment is more common among people with diabetes than among people without diabetes. In fact, hearing loss has been reported at approximately twice the rate in people with diabetes compared with people of similar ages who do not have the condition.
The connection isn't completely understood, but researchers believe damage involving the tiny blood vessels and nerves of the inner ear may contribute.
Hearing loss also tends to develop gradually. You may not wake up one morning suddenly unable to hear. Instead, conversations can slowly become harder to follow, televisions become louder, and crowded restaurants become increasingly frustrating.
Because these changes can be subtle, hearing health deserves a place alongside eye exams, kidney screening, foot care, and other aspects of comprehensive diabetes management.
How Does Hearing Work?
Understanding the diabetes connection starts with understanding how sensitive the hearing system is.
Sound waves enter the ear and eventually reach the inner ear, which contains a delicate structure called the cochlea.
Inside the cochlea are specialized sensory cells that help transform sound vibrations into electrical signals.
Those signals travel through the auditory nerve to the brain, where they are interpreted as speech, music, environmental sounds, and other auditory information.
This system depends on:
- Healthy sensory cells
- Healthy nerves
- Adequate blood supply
- Proper transmission of nerve signals
- These structures are extremely small and delicate.
That matters because diabetes can affect both small blood vessels and nerves throughout the body.
Why Is Hearing Loss More Common with Diabetes?
Researchers are still working to understand the exact relationship.
One leading explanation involves microvascular damage.
Persistently elevated blood glucose can damage small blood vessels throughout the body. Similar processes contribute to well-known diabetes complications involving the eyes and kidneys.
The inner ear also depends on an extensive network of tiny blood vessels.
Damage to these vessels may interfere with the oxygen and nutrients needed to maintain normal hearing.
Another possible factor is nerve damage.
Diabetes can damage nerves throughout the body, a complication commonly known as diabetic neuropathy.
Researchers believe diabetes-related changes may also affect nerves involved in carrying sound information from the inner ear to the brain.
The relationship is probably complex and may involve several biological processes rather than one single cause.
How Common Is Hearing Loss Among People with Diabetes?
Hearing impairment is considerably more common among people with diabetes.
Research cited by major diabetes health organizations has found hearing loss to be approximately twice as common among adults with diabetes compared with people of similar ages without diabetes.
Interestingly, the association may begin even before someone develops Type 2 diabetes.
Studies have also found higher rates of hearing impairment among people with prediabetes compared with those whose glucose is within the normal range.
This doesn't mean everyone with diabetes will develop hearing loss.
It does mean hearing health is worth paying attention to.
Hearing Loss Can Develop Slowly
One reason hearing loss is easy to overlook is that it often develops gradually.
The brain adapts remarkably well to small changes.
You may not realize that certain sounds have become harder to hear because you unconsciously compensate by:
- Turning up the television
- Watching people's lips
- Asking people to repeat themselves
- Moving closer during conversations
- Avoiding noisy environments
- Sometimes family members notice the problem first.
They may comment that the television is unusually loud or that you frequently misunderstand conversations.
These observations shouldn't automatically be dismissed as part of normal aging.
Early Signs of Hearing Loss
Possible warning signs include:
- Frequently asking people to repeat themselves
- Feeling that other people are mumbling
- Difficulty following group conversations
- Trouble understanding speech in restaurants or crowded rooms
- Turning the television or radio louder than others prefer
- Difficulty hearing softer or higher-pitched voices
- Missing phone calls, alarms, or doorbells
- Frequently misunderstanding words
- Feeling exhausted after conversations
- Avoiding social situations because hearing is difficult
- One symptom alone does not necessarily mean you have significant hearing loss.
- However, recurring problems deserve evaluation.
- Why High-Pitched Sounds May Become Difficult First
Diabetes-associated hearing impairment frequently affects higher-frequency sounds.
High-frequency hearing is important for understanding certain components of speech.
Someone may be able to hear that another person is speaking while still having trouble understanding exactly what is being said.
Words can begin to sound less clear rather than simply quieter.
This can be particularly noticeable when:
- Several people are talking
- Background music is playing
- You're speaking on the telephone
- Someone is talking from another room
- You're in a busy restaurant
This is one reason people sometimes believe everyone else has started “mumbling.”
The problem may actually involve hearing clarity.
Age and Diabetes Can Both Affect Hearing
Hearing commonly changes with age.
That can make it difficult to determine whether hearing loss is related specifically to diabetes.
Someone with diabetes may also have several other hearing-loss risk factors, including:
- Older age
- Long-term noise exposure
- Cardiovascular disease
- Smoking
- Certain medications
- Family history
- These factors can overlap.
Rather than trying to determine the cause yourself, focus on recognizing changes and having your hearing professionally evaluated when appropriate.
Hearing Loss Can Affect More Than Conversations
Hearing is closely connected to daily functioning.
Difficulty hearing can affect:
- Communication
- Relationships
- Work
- Independence
- Social participation
- Safety
- Quality of life
Someone who struggles to understand conversations may gradually begin avoiding restaurants, parties, meetings, or other social situations.
That isolation can affect emotional well-being.
Hearing difficulties may also make medical appointments harder.
If you cannot clearly hear medication instructions, insulin dosing information, or recommendations from your healthcare team, diabetes management itself can become more difficult.
Hearing Matters for Diabetes Technology
Modern diabetes devices frequently communicate through sound.
CGMs, insulin pumps, glucose meters, smartphones, and related technologies may use audible alarms or notifications to warn about:
- Low glucose
- Predicted hypoglycemia
- High glucose
- Pump problems
- Insulin delivery interruptions
- Device errors
- Someone with significant hearing impairment may not reliably hear these alerts.
If you use diabetes technology and have difficulty hearing notifications, discuss accessibility options with your healthcare team and review the settings available on your device.
Some systems may offer vibration, smartphone, smartwatch, caregiver-sharing, or other notification options.
Protect Your Hearing from Loud Noise
Diabetes isn't the only potential threat to hearing.
Repeated exposure to loud noise can permanently damage structures within the inner ear.
Protect your hearing around:
- Power tools
- Lawn equipment
- Concerts
- Firearms
- Loud machinery
- Motorcycles
- High-volume headphones
- Use appropriate hearing protection when exposed to potentially damaging sound.
When listening through headphones or earbuds, avoid unnecessarily high volume levels.
Diabetes may be one risk factor you cannot completely eliminate, but excessive noise exposure is one you can often reduce.
Blood Glucose Management May Matter
Maintaining glucose within your individualized target range is important for reducing the risk of many diabetes complications.
Because blood vessel and nerve damage are among the proposed explanations for diabetes-associated hearing impairment, good overall diabetes management is another reason to take glucose goals seriously.
That includes:
- Taking medications as prescribed
- Monitoring glucose as recommended
- Eating a balanced diet
- Staying physically active
- Managing blood pressure
- Managing cholesterol
- Avoiding tobacco
- Attending regular healthcare appointments
- No strategy can guarantee that hearing loss will never occur.
- The goal is to reduce modifiable risks while detecting problems early.
- Don't Ignore Sudden Hearing Loss
- Most age- or diabetes-associated hearing impairment develops gradually.
- Sudden hearing loss is different.
If hearing suddenly disappears or becomes significantly worse—particularly in one ear—seek medical evaluation promptly.
Do not simply assume that the ear is blocked with wax or that the problem will resolve on its own.
Sudden sensorineural hearing loss can require urgent assessment and treatment.
Make Hearing Part of Your Diabetes Care
Hearing may not receive as much attention as A1C, kidney tests, eye examinations, or foot checks, but it deserves a place in comprehensive diabetes care.
Ask yourself periodically:
Am I asking people to repeat themselves more often?
Has the television volume gradually increased?
Are conversations harder to understand?
Do restaurants seem unusually difficult?
Am I missing alarms or notifications?
Have friends or family mentioned my hearing?
If the answer to several of these questions is yes, discuss hearing evaluation with your healthcare provider.
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Hearing problems can develop gradually enough that you may not notice them yourself.
That is one reason routine screening can be useful.
Current diabetes guidance recognizes hearing impairment as an important issue for people with diabetes. Your healthcare provider may ask about hearing difficulties during routine diabetes visits and recommend further evaluation when appropriate.
A hearing evaluation is particularly worth discussing if you:
- Frequently ask people to repeat themselves
- Have difficulty following conversations
- Struggle to understand speech in noisy places
- Regularly turn the television louder
- Have ringing in your ears
- Miss alarms or notifications
- Have family members concerned about your hearing
You do not need to wait until hearing loss becomes severe before asking for help.
What Happens During a Hearing Evaluation?
A professional hearing assessment is usually straightforward and painless.
Depending on your symptoms, testing may include examining the ear canal and measuring how well you hear sounds at different frequencies and volumes.
You may also be asked to identify words or speech under different conditions.
The results can help determine:
- Whether hearing loss is present
- How significant it is
- Which frequencies are affected
- Whether one or both ears are involved
- Whether additional medical evaluation is necessary
- Not every hearing problem is caused by permanent inner-ear damage.
Earwax buildup, infections, fluid behind the eardrum, and other conditions can also interfere with hearing.
That is another reason professional evaluation is preferable to assuming diabetes is responsible.
What Is an Audiologist?
An audiologist is a healthcare professional who specializes in hearing and balance disorders.
Audiologists can:
- Perform hearing tests
- Identify patterns of hearing loss
- Recommend hearing aids
- Fit and adjust hearing devices
- Suggest assistive listening technology
- Provide communication strategies
- Monitor changes over time
Depending on your symptoms, you may also be referred to an ear, nose, and throat physician—often called an ENT or otolaryngologist.
Medical evaluation may be particularly important when hearing loss is sudden, affects one ear much more than the other, or occurs with other concerning symptoms.
Hearing Aids Have Become More Advanced
For people with permanent hearing loss, hearing aids can make speech and environmental sounds easier to hear.
Modern hearing aids are considerably more sophisticated than older devices.
Depending on the model, features may include:
- Digital sound processing
- Rechargeable batteries
- Bluetooth connectivity
- Smartphone controls
- Directional microphones
- Noise reduction
- Multiple listening programs
Some devices can connect directly to phones, televisions, and other electronics.
Hearing aids do not restore hearing to exactly what it was before hearing loss developed, but properly fitted devices can substantially improve communication for many people.
Over-the-Counter Hearing Aids May Be an Option for Some Adults
In the United States, certain hearing aids are available over the counter for adults with perceived mild to moderate hearing loss.
This can make hearing assistance more accessible for some people.
However, over-the-counter devices are not appropriate for every hearing problem.
Professional evaluation may be preferable if you have:
- Sudden hearing loss
- Significant difference between ears
- Ear pain
- Drainage from the ear
- Persistent dizziness
- Severe hearing difficulty
- Uncertainty about the cause of your symptoms
Even when an over-the-counter device is appropriate, an audiologist can help you understand your hearing needs and available options.
Assistive Technology Can Help
Hearing aids are not the only tools available.
Assistive listening and accessibility features can make everyday communication easier.
Examples include:
- Captioned telephone services
- Television captions
- Smartphone transcription
- Visual alarms
- Vibrating alarms
- Amplified telephones
- Remote microphones
- Smartwatch notifications
These features can be particularly useful for someone using diabetes technology.
For example, if you cannot reliably hear a CGM or insulin pump alert, vibration or connected-device notifications may provide an additional warning.
Review accessibility settings on the devices you depend on.
Tell Your Diabetes Care Team About Hearing Difficulties
Hearing loss can interfere with healthcare communication.
If you have difficulty hearing during medical appointments, tell the staff rather than trying to hide the problem.
Helpful strategies may include:
- Asking the clinician to face you when speaking
- Requesting written instructions
- Reducing background noise
- Bringing a trusted family member when appropriate
- Using hearing devices
- Confirming medication instructions before leaving
- After an appointment, you should clearly understand:
- Medication changes
- Insulin instructions
- Glucose targets
- Tests you need
- Follow-up appointments
- Symptoms requiring medical attention
Misunderstanding medical instructions because of hearing difficulty can create unnecessary risks.
What About Tinnitus?
Tinnitus refers to hearing sounds that do not come from an external source.
People often describe tinnitus as:
- Ringing
- Buzzing
- Hissing
- Humming
- Clicking
Tinnitus can occur with hearing loss, noise exposure, certain medications, and several other conditions.
Having diabetes does not mean tinnitus is necessarily caused by diabetes.
If tinnitus is persistent, worsening, affecting only one ear, or interfering with sleep and daily life, discuss it with a healthcare professional.
Tinnitus accompanied by sudden hearing loss or significant dizziness deserves prompt medical attention.
Diabetes and Balance Problems
The inner ear also contributes to balance.
However, dizziness or balance difficulties in someone with diabetes can have many possible causes.
These may include:
- Inner-ear disorders
- Low blood glucose
- Blood pressure changes
- Dehydration
- Medication side effects
- Peripheral neuropathy
- Vision problems
Neuropathy can reduce sensation in the feet, while vision problems can reduce visual information used for balance. Together, these changes may increase fall risk.
Do not assume recurrent dizziness is simply a normal part of diabetes.
Tell your healthcare provider, especially if symptoms are new, severe, or associated with fainting, weakness, speech problems, chest pain, or other concerning symptoms.
Review Your Medications
Certain medications can affect hearing or balance.
These are sometimes described as ototoxic medications because they can damage structures involved in hearing.
The risk depends on the specific medication, dose, treatment duration, and individual health factors.
If you notice hearing changes after starting a medication, tell your healthcare provider or pharmacist.
Do not stop prescribed medication on your own.
Your healthcare team can determine whether the medication could be contributing and whether another approach is appropriate.
Protect Both Your Hearing and Cardiovascular Health
The inner ear depends on healthy circulation.
Many strategies already recommended for diabetes and cardiovascular health may therefore support overall hearing health as well.
These include:
- Managing blood glucose
- Managing blood pressure
- Managing cholesterol
- Exercising regularly
- Avoiding tobacco
- Eating a nutritious diet
- Attending recommended healthcare visits
These habits cannot prevent every form of hearing loss, but they support the blood vessels and nerves throughout the body.
Stop Smoking and Avoid Tobacco
Smoking damages blood vessels and is associated with numerous cardiovascular and diabetes-related complications.
Because hearing depends on adequate blood flow to delicate structures in the inner ear, avoiding tobacco is another sensible component of protecting overall health.
If you smoke and want to quit, ask your healthcare provider about evidence-based cessation support.
Be Careful with Earwax Removal
Earwax can sometimes cause temporary hearing difficulty.
However, inserting cotton swabs, hairpins, or other objects deep into the ear can push wax farther inside or damage the ear canal or eardrum.
If you suspect impacted earwax, ask a healthcare professional about safe removal.
Do not assume that worsening hearing is caused by wax without an appropriate evaluation.
Hearing Loss Can Affect Emotional Health
Communication connects people.
When hearing becomes difficult, someone may begin avoiding:
- Restaurants
- Family gatherings
- Meetings
- Religious services
- Community activities
- Phone conversations
- Social withdrawal can contribute to loneliness and emotional distress.
Hearing impairment has also been associated with cognitive and mental health concerns, particularly when significant hearing difficulty remains untreated.
If hearing problems are causing you to withdraw from people or activities you enjoy, seek help.
Addressing hearing loss is about more than making sounds louder. It can help preserve communication, relationships, independence, and quality of life.
Family Members Can Help Identify Changes
Because hearing loss often develops gradually, people close to you may notice changes first.
They might say:
- “The TV is getting really loud.”
- “You keep asking me to repeat myself.”
- “You didn't hear your phone.”
- “You seem to misunderstand what people are saying.”
- These comments can be frustrating, but they may provide useful information.
Rather than arguing about whether your hearing has changed, consider scheduling an objective hearing evaluation.
Hearing Health Belongs in Preventive Diabetes Care
People with diabetes already have many preventive healthcare responsibilities.
Adding another screening may seem burdensome.
However, hearing difficulties can affect safety, communication, diabetes self-management, and overall quality of life.
Hearing health can be incorporated into the same preventive mindset used for:
- Eye examinations
- Kidney screening
- Foot examinations
- Dental care
- Blood pressure checks
- Cholesterol monitoring
- The purpose isn't to assume that diabetes will damage your hearing.
- It is to recognize increased risk and respond early when changes occur.
- Frequently Asked Questions
- Does diabetes cause hearing loss?
Diabetes is associated with a higher prevalence of hearing impairment. Researchers believe diabetes-related changes involving small blood vessels and nerves may contribute, although hearing loss can have many causes.
How much more common is hearing loss in people with diabetes?
Research has found hearing impairment to be approximately twice as common among adults with diabetes compared with adults of similar ages without diabetes.
Can prediabetes affect hearing?
Research has also found a higher prevalence of hearing impairment among people with prediabetes compared with people whose glucose levels are within the normal range. More research is needed to fully understand this relationship.
Can better blood sugar control restore hearing?
Managing glucose is important for overall health and reducing diabetes-related complications, but established permanent sensorineural hearing loss generally cannot be reversed simply by lowering glucose. Hearing aids and other interventions may help when permanent hearing loss is present.
Should I get my hearing tested even if I don't notice a problem?
Current diabetes guidance recognizes the importance of hearing screening. Discuss your individual screening needs with your healthcare provider, particularly if you have diabetes-related risk factors or subtle communication difficulties.
Are hearing aids safe for people with diabetes?
Yes. Diabetes does not generally prevent someone from using hearing aids. An audiologist can recommend an appropriate device based on the type and degree of hearing loss.
Can hearing loss make diabetes management harder?
It can. Difficulty hearing healthcare instructions or alarms from glucose monitors and insulin devices may interfere with diabetes management. Accessibility features and written instructions can help.
What should I do if I suddenly lose hearing in one ear?
Seek prompt medical evaluation. Sudden hearing loss can represent a medical problem requiring urgent assessment and should not simply be assumed to be earwax or a diabetes complication.
Key Takeaways
Hearing impairment is an often-overlooked health concern for people with diabetes.
Research suggests hearing loss occurs more frequently among adults with diabetes, possibly because diabetes can affect the small blood vessels and nerves required for healthy hearing.
Hearing loss usually develops gradually. Warning signs include frequently asking people to repeat themselves, turning up the television, struggling to understand conversations in noisy environments, and missing alarms or notifications.
Professional hearing evaluation can identify whether hearing loss is present and determine whether treatment, hearing aids, assistive technology, or additional medical evaluation is appropriate.
People using CGMs, insulin pumps, and other diabetes technology should make sure they can reliably receive important alerts. Vibration, smartphone notifications, smartwatches, caregiver sharing, and other accessibility features may help.
Protect your hearing from excessive noise and avoid inserting objects into your ears to remove wax.
Continue managing blood glucose, blood pressure, cholesterol, physical activity, and tobacco exposure as part of protecting your overall vascular and neurological health.
Most importantly, don't dismiss changes in hearing simply because you're getting older or have diabetes. Hearing problems can affect communication, safety, relationships, and your ability to manage your health.
Early recognition and appropriate treatment can help you stay connected—to the people around you and to the information you need to manage diabetes successfully.
This article provides general educational information and is not a substitute for personalized medical advice.