How Diabetes and Hearing Loss Are Connected: What You Need to Know

If you or someone you care about lives with diabetes, you’re probably already familiar with the many potential complications — from vision changes and neuropathy to cardiovascular risk. What’s less well known, however, is the connection between diabetes and hearing loss.

In fact, growing evidence suggests that people with diabetes are at significantly higher risk of hearing impairment than those without. In this post, we’ll explain what we currently know, share tips for protecting your hearing, and clarify when to see a hearing professional.

In short: the data strongly suggest a meaningful association between diabetes (and elevated blood sugar) and hearing damage. That said, the exact cause-and-effect pathways are still under investigation.

Why Might Diabetes Affect Hearing?

The inner ear (cochlea and associated nerves) is a delicate, high-metabolic organ that relies on precise blood supply and neural signaling. Diabetes and chronically high blood sugar levels can disrupt those systems in several ways:

• Microvascular damage: Just as diabetes can damage small blood vessels in the eyes (retinopathy) and kidneys (nephropathy), it may also harm the tiny capillaries that feed the cochlea and inner ear structures.
• Neural (nerve) damage/neuropathy: Diabetes can damage nerves throughout the body; similarly, it may impair the auditory nerve or connections from the inner ear to the brain.
• Oxidative stress and inflammation: Elevated glucose may promote oxidative damage and inflammation, which can injure hair cells (sensory cells) and supporting structures in the cochlea.
• Metabolic/insulin signaling dysfunction: Some studies suggest that insulin/glucose signaling pathways themselves may influence inner-ear homeostasis, and in type 2 diabetes, disruption of those pathways may contribute to cochlear damage.
• Link with other diabetic complications: Individuals with more advanced microvascular damage—e.g. retinopathy—also tend to have worse hearing thresholds, pointing to a common underlying vascular vulnerability.

Because many of these mechanisms are overlapping and gradual, hearing loss in diabetes is generally sensorineural (inner ear/nerve-based) and tends to develop slowly.

Who Is Most at Risk?

Not every person with diabetes will experience noticeable hearing loss, and other risk factors also play a role. But here are factors that appear to increase vulnerability:

• Longer duration of diabetes: The longer someone has had elevated blood sugars, the more time accumulates for damage.
• Poor glycemic control (high HbA1c): Some studies show that hearing loss is more common when HbA1c is poorly controlled (e.g. ≥ 8%) versus better control.
• Existing microvascular complications: Those with diabetic retinopathy or nephropathy are more likely to show hearing deficits.
• Younger age groups (paradoxically): In one cohort study, the relative risk of hearing loss associated with diabetes was stronger among participants under 50 than older individuals.
• Other risk factors: Hypertension, smoking, high lipids, exposure to noise, and use of ototoxic medications can compound the risk.

Given this, hearing health should be on the radar especially for people with longstanding, uncontrolled, or complicated diabetes.

What You Can Do to Protect Your Hearing

While we can’t yet definitively reverse hearing loss caused by diabetes, there are proactive steps that may help slow or mitigate the damage:

• Tight glycemic control: Maintaining your blood sugar within target ranges reduces the long-term stress on vascular and neural structures. Some research links better control to lower risk of hearing decline.
• Manage comorbidities: Keep blood pressure, cholesterol, and other vascular risk factors in check. Avoid or halt smoking. These help preserve microvascular health.
• Protect your ears from noise: Loud sound exposure compounds risk. Use ear protection (earplugs, earmuffs) in noisy environments (concerts, machinery, etc.).
• Limit or monitor ototoxic medications: Some drugs (certain antibiotics, diuretics, etc.) can injure hearing. If you’re prescribed any potentially ototoxic medications, speak with your physician or audiologist about alternatives or monitoring.
• Annual hearing screening: Don’t wait until problems become obvious — regular yearly hearing checks are recommended for people with diabetes. The CDC in fact encourages yearly ear health screening in diabetic patients.
• Stay active & support vascular health: Exercise, good hydration, and a healthy diet support circulation and reduce overall vascular stress.
• Use hearing technology where needed: If hearing loss is confirmed, hearing aids or assistive listening devices can meaningfully improve your communication and quality of life, even if they don’t reverse the underlying damage.