“A CLINICAL STUDY TO EVALUATE THE ASSOCIATION OF HBA1C TITRES IN TYPE 2 DIABETES MELLITUS AND SEVERITY OF SENSORINEURAL HEARING LOSS”
Main Article Content
Keywords
Type 2 Diabetes Mellitus, Sensorineural Hearing Loss, HbA1c, Glycaemic control, Pure Tone Audiometry
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder associated with several complications, including the underrecognized impact on auditory function. Sensorineural hearing loss (SNHL), particularly at higher frequencies, may be influenced by poor glycaemic control, as reflected by elevated HbA1c levels.
Objective: To evaluate the association between HbA1c titres and the severity of SNHL in patients with T2DM.
Methods: This cross-sectional observational study was conducted over 12 months at a tertiary care hospital in India, enrolling 70 T2DM patients aged 30–75 years. Patients underwent HbA1c testing and Pure Tone Audiometry (PTA). SNHL severity was categorized using WHO grades, and associations with HbA1c were statistically analyzed using chi-square, Pearson correlation, and ROC analysis.
Results: The majority of participants were aged 60–69 years (34%), with moderate or severe SNHL. Poor glycaemic control was common, with 37% of participants having sub-optimal HbA1c levels (7–8.9%) and 37% with poor control (≥9%). The severity of SNHL showed a clear association with glycaemic status: 33% of those with HbA1c < 7%, 54% with HbA1c 7–8.9%, and 100% with HbA1c ≥ 9% had moderate or severe SNHL (p < 0.001). ROC analysis identified an HbA1c cut-off of 8.7% for predicting moderate SNHL, with good diagnostic accuracy (AUC 0.79, sensitivity 77%, specificity 72%).
Conclusion: Poor glycaemic control is significantly associated with increased SNHL severity in T2DM patients. Audiological screening should be integrated into routine diabetic care to detect early hearing impairment.
References
2. Tanna, R. J., Lin, J. W., & De Jesus, O. (2023, August 23). Sensorineural Hearing Loss.
3. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007 Mar;125(3):217–230.
4. Sherwani, S. I., Khan, H. A., Ekhzaimy, A., Masood, A., & Sakharkar, M. K. (2016). Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomarker Insights, 11, 95–104
5. Schnell, O., Crocker, J. B., & Weng, J. (2017). Impact of HbA1c testing at point of care on diabetes management. Journal of Diabetes Science and Technology, 11(3), 611–617.
6. Fukushima, H., et al. (2006). Effects of Type 2 Diabetes Mellitus on Cochlear Structure in Humans. Archives of Otolaryngology–Head & Neck Surgery.
7. Lee, J.-H., et al. (2022). Age-related hearing loss accelerated by apoptosis of spiral ganglion and stria vascularis cells in ApoE KO mice with hyperglycemia and hyperlipidemia. Frontiers in Aging Neuroscience, 14, 930105
8. Mahmood K, Aamir AH. Glycemic control status in patients with type-2 diabetes. J Coll Physicians Surg Pak. 2005;15(6):323–325.
9. Kullberg C. Long-term glycaemic control and complications in Type 1 diabetes. Diabetologia. 1995;38(3):292–298.
10. World Health Organization. World report on hearing. Geneva: World HealthOrganization; 2021. 314 p. Licence: CC BY-NC-SA 3.0 IGO.
11. Pemmaiah KD, Srinivas DR. Hearing loss in Diabetes Mellitus. Int J Collab Res Intern Med Public Health. 2011;3(5).
12. Quines MR, Gloria CE. Association of Glycemic Index Using HbA1c and Sensorineural Hearing Loss in Diabetes Mellitus Type 2 Patients: A Systematic Review and Meta-Analysis. Philipp J Otolaryngol Head Neck Surg. 2023;38(1).
13. Li M, Perlov N, Patel J, Amin D, Kumar A, Urdang ZD, Willcox TO, Chiffer RC. Association of type 2 diabetes mellitus with sensorineural hearing loss: A population-based analysis. Neuro Endocrinol Lett. 2024;45(5):341–351.
14. Kaur G, Srivastava SP. Effect of Diabetes Mellitus on Hearing. 2019;4(1):24–29.
15. Jyoti J, Ali I, Abbas SW. Association of sensorineural hearing loss in type 2 diabetes mellitus patients: an analytical cross sectional study. Int J Otorhinolaryngol Head Neck Surg. 2021;7(11).
16. Kumar P, Mishra S, Prakash V, Singh R. Correlation between value of Hba1c and degree of sensorineural hearing loss in type 2 diabetics. Int J Res Med Sci. 2023;11(5).
17. Srinivas C, Shyamala V, Shiva Kumar BS. Clinical Study to Evaluate the Association Between Sensorineural Hearing Loss and Diabetes Mellitus in Poorly Controlled Patients Whose HbA1c >8. Indian J Otolaryngol Head Neck Surg. 2016;68:191–195
18. Vybhavi MK, Srinivas V, Muddaiah D. A cross sectional study of prevalence and association of sensorineural hearing loss in patients with type 2 diabetes mellitus. Int J Otorhinolaryngol Head Neck Surg. 2024;10(2)..
19. Tiwari A, Mudhol R. Prevalence of sensorineural hearing loss among type-II diabetes mellitus patients attending KLES Dr. Prabhakar Kore Hospital and MRC: A cross-sectional study. Indian J Health Sci Biomed Res. 2018;11(3):165–169.
20. Kumar S. A Study to correlate incidence and association of sensorineural hearing loss and retinopathy in patients with diabetes mellitus. 2016
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Neha Kishnani
Department Of Otorhinolaryngology at Pacific Institute of Medical Sciences, Udaipur, India
Dr Satyam
Department Of Otorhinolaryngology at Pacific Institute of Medical Sciences, Udaipur, India
Prof. Dr Vikram Singh Rathore
Department Of Otorhinolaryngology at Pacific Institute of Medical Sciences, Udaipur, India