Diabetes and Hearing: What Happens to the Ears When the Blood Sugar Stays High

A Connection That Many Persons Discover Too Late

In Italy, we have a saying: “Chi non sente, non vede” — who does not hear, does not see. And yet, when a person receives the diagnosis of diabetes, the first preoccupations are always the same: the eyes, the kidneys, the feet. The ears? Almost nobody speaks of the ears.

This is a grave error, and I say this with the conviction of having observed this pattern for many years. The research has demonstrated with clarity that the persons with diabetes present a risk of hearing loss nearly two times superior to who does not have this condition. The mechanism is not mysterious, but it is often ignored, and this ignorance costs dearly.

The purpose of this text is to explain, with simple words but with the depth that the subject merits, how the management of diabetes and the preservation of hearing are two faces of the same coin. And, above all, what it is possible to do, concretely, every day.

How the Excess of Sugar Damages the Inner Ear

Let us proceed with order. The inner ear contains thousands of tiny hair cells and a network of very small blood vessels that nourish them. These structures are delicate in an extreme way. They do not have the capacity to regenerate, and this is the point that makes everything more serious.

When the glycemia remains elevated for prolonged periods, two things happen in parallel:

• The microcirculation deteriorates. The small vessels that bring oxygen and nutrients to the cochlea become rigid, narrow, and less efficient. It is the same process that damages the retina or the renal glomeruli, but in the ear it passes silently for years.
• The nerve fibres suffer oxidative stress. The excess of glucose generates free radicals that attack the auditory nerve directly. The signal arrives to the brain with difficulty, distorted, incomplete.

The result is not a sudden deafness. It is something more insidious: a progressive difficulty to comprehend the words, above all in the environments with background noise. The person hears the sound, but does not distinguish the syllables. And often attributes this to the age, without connecting it to the metabolic condition.

The Warning Signs That Should Not Be Ignored

It is necessary to listen to the body before that the damage becomes irreversible. The signs that should make a diabetic person raise the attention are these:

1. The necessity to ask the interlocutor to repeat, above all in the restaurants or in the family gatherings.
2. The sensation that the others “murmur” or speak without clarity.
3. The difficulty to follow the conversations in which more persons speak together.
4. A persistent tinnitus — a whistle, a buzz — that was not present before.
5. The tendency to augment the volume of the television beyond what the family finds comfortable.

If two or three of these signs are present, it is not a question of waiting. It is a question of acting.

The Pillars of a Strategy That Protects Both the Glycemia and the Hearing

Here arrives the practical part, the one that truly matters. The management that protects the hearing in a diabetic person is not a separate protocol. It is the same good management of the diabetes, enriched with some specific attentions.

The studies have shown that the persons who maintain the glycated haemoglobin below the 7% present a deterioration of the auditory function notably more slow. This means that every effort to keep the glycemia stable — through the alimentation, the movement, the eventual pharmacological therapy — is also an effort to protect the ears.

The practical indications:

• To prefer the complex carbohydrates with low glycaemic index (legumes, whole cereals, vegetables).
• To avoid the peaks of sugar that create micro-damages to the vessels every day.
• To monitor the glycemia with regularity, not only when the physician asks it.

The movement improves the microcirculation in all the districts of the body, included the cochlea. It is not necessary to run the marathon. Thirty minutes of brisk walking, five times at the week, are already sufficient to make a difference. The swimming, the cycling, the dance — any activity that elevates the heart rate in moderate way — contributes to maintain the small vessels elastic and functional.

This point is often forgotten. The ear already fragilised by the diabetes is much more vulnerable to the acoustic trauma. In the practice, this means:

• To use the protections in the noisy environments (the factories, the concerts, the works with the power tools).
• To limit the use of the earphones at high volume.
• To respect the moments of acoustic silence during the day, to permit to the hair cells to recover.

The hypertension, the dyslipidaemia, the smoke — all these elements aggravate the vascular damage also at the level of the inner ear. To manage the diabetes well but to continue to smoke, for example, is like to protect the house from the rain but to leave the windows open during the storm.

The Nutritional Support: What the Science Suggests

Here I wish to open a parenthesis that is important. The alimentation of the diabetic person is often restrictive, and this can create lacunas in some micronutrients that are fundamental for the auditory function: the magnesium, the zinc, the B vitamins, the antioxidants.

In the cases in which the diet alone is not sufficient, a targeted integration can have sense. I have observed, for example, that some formulations studied specifically for the auditory support — as Acuvit, which one can examine in detail on acuvit.health — propose a combination of nutrients oriented to sustain the microcirculation of the inner ear and to contrast the oxidative stress. I do not say this as a solution that resolves everything, but as a possible tassello of a more ample strategy, always to discuss with the own physician.

The principle is simple: if the vessels of the cochlea need oxygen, antioxidants, and specific minerals to function, it is logical to verify that these elements arrive in sufficient quantity. This is valid for the diabetic person and for any person that wishes to preserve the hearing with the passing of the years.

The Regular Auditory Check-Up: A Habit to Introduce

In Italy we go from the oculist every year, from the dentist every year. But from the audiologist? Almost never, unless there is already a problem.

The persons with diabetes should insert an auditory control every twelve months, or at maximum every two years. It is a simple examination, not invasive, that permits to catch the small variations before that they become a handicap. The early detection changes everything, because it permits to intervene when the margin of action is still ample.

In Conclusion: The Hearing Is Not a Luxury

I wish to close with a reflection that comes from the experience. The hearing is not only a sense. It is the thread that connects us to the others, to the conversations at the table, to the voice of the grandsons, to the music that accompanied our life. To lose it little by little, without noticing, is to lose a piece of social life, of autonomy, of joy.

The diabetic person that manages the glycemia with constancy, that moves the body, that protects the ears from the noise, that verifies the nutritional contributions — also through specific integrations when the physician considers it appropriate — is not doing something extraordinary. Is doing something of profound common sense. Is treating the body as a whole, and not as a collection of separate organs.

And this, in the end, is the true medicine: the attention, the regularity, the respect for the small signals that the body sends us every day. The ears speak. It is sufficient to listen.