Hearing loss is a common occurrence in patients with Diabetes. These individuals need unique care when considering hearing instruments.
Diabetes results when insulin, a hormone produced by the pancreatic beta cells, is either not adequately produced or its normal function in the body is impaired. Insulin transports glucose into the cell for use as energy and storage. There are four main forms of diabetes Type 1, Type 1.5, Type 2 and (GDM) gestational. Of the four it is Type 2 diabetes that accounts for 95% of all diabetic cases in the United States.
Hearing loss is about twice as common in adults with type II diabetes as compared to the general population.
Researchers have found that the diabetes may lead to sensorineural hearing loss by damaging the nerves and or the blood vessels of the inner ear due to the pathologic changes that are associated with this condition.
Diabetics also have higher than usual incidence of abnormal loudness perceptions. This means that as the loudness of a sound is increased, a diabetic patient may perceive the sound is actually much louder than someone with normal hearing. This can present problems in providing proper amplification or in the the process of adapting to hearing instruments.
Other conditions found in the diabetic patient include diabetic retinopathy which damages the small blood vessels in the retina. Diabetic retinopathy can result in poor vision and even blindness. This can lead to a number of problems in the fitting of hearing instruments. If the patient is not able to see their hearing aids well enough this could compromise daily maintenance, the changing of batteries among other things.
Another common symptom found in a diabetic patient is neuropathy. Diabetic neuropathy interrupts the normal flow of the nerve signals to various parts the body. This may limit a patient’s ability to feel pain which is one of the ways the body protects itself against injury. This also reduces the patient’s ability to sense pain, touch, temperature and vibration all which results from damage to the peripheral nervous system When a diabetic patient loses feeling in their fingertips the insertion, removal of hearing aids, as well as changing batteries can become much more difficult.
Diabetics can also have increased hypersensitivity with skin contact due to epithelial atrophy. Special accommodations may be needed where the hearing aids make contact with skin over or in the ear. Using materials to soften the contact areas and at times using hypoallergenic materials may be helpful. Some shell labs offer removal or absence of color pigmentation to achieve a hypoallergenic shell and some offer clear or translucent shells.
In addition to problems with hearing diabetic patients also may have vestibular problems. While not directly affecting hearing loss, problems with dizziness and vertigo create a whole other set of issues.
Management of the diabetic patient should be a multidisciplinary team approach which includes the primary care specialist, endocrinologist, diabetic educator and dietitian, cardiology, orthopedics, podiatry, physical therapy, otolaryngology, dermatology, ophthalmology as well as Audiology.