Jinnah Sindh Medical University, Karachi, Pakistan.
Jinnah Sindh Medical University, Karachi, Pakistan
BMJ Open. 2024 May 1;14(5):e081035. doi: 10.1136/bmjopen-2023-081035.
Despite potential links between diabetes and sensorineural hearing loss (SNHL), routine hearing assessments for diabetic patients are not standard practice. Our study aimed to investigate the prevalence of SNHL and its association with diabetes-related factors among patients with type 2 diabetes mellitus (T2DM).
This cross-sectional study was conducted at the Diabetes Clinic, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from May to September 2021. A total of 396 patients fulfilling the inclusion criteria participated after informed consent. Data collection involved a sociodemographic profile, Michigan Neuropathy Screening Instrument examination followed by pure-tone audiometry and laboratory tests including haemoglobin A1C (HbA1c). HL was defined using better ear four-frequency pure-tone average of ≥26 dB HL and graded as per WHO criteria. Statistical analyses were performed using SPSS. χ, independent ttest and multinomial logistic regression analyses were applied. P<0.05 at 95% CI was considered significant.
Our study revealed a high prevalence of SNHL among patients with T2DM. Mild HL was seen in 55.8%, while 18.7% suffered from moderate HL. Common audiological symptoms included difficulty understanding speech in noisy surroundings (44.2%), balance problems (42.9%), sentence repetition (35.9%), tinnitus (32.3%) and differentiating consonants (31.1%). Hearing impairment predominantly affected low (0.25-0.5 kHz) and high (4-8 kHz) frequencies with a significant difference at 4 kHz among both sexes ( (394)=2.8, p=0.004). Peripheral neuropathy was significantly associated with SNHL on multinomial logistic regression after adjusting with age, sex, body mass index and the presence of any comorbidities. Diabetes duration, HbA1c or family history of diabetes was found unrelated to SNHL severity.
The study highlights the substantial prevalence of SNHL among patients with T2DM and emphasises the importance of targeted audiological care as part of a holistic approach to diabetes management. Addressing HL early may significantly improve communication and overall quality of life.
尽管糖尿病与感音神经性听力损失(SNHL)之间存在潜在联系,但对糖尿病患者进行常规听力评估并非标准做法。我们的研究旨在调查 2 型糖尿病(T2DM)患者中 SNHL 的患病率及其与糖尿病相关因素的关系。
本横断面研究于 2021 年 5 月至 9 月在巴基斯坦卡拉奇的吉纳纳研究生医学中心的糖尿病诊所进行。共有 396 名符合纳入标准的患者在知情同意后参与了研究。数据收集包括社会人口统计学特征、密歇根神经病变筛查工具检查,随后进行纯音测听和实验室检查,包括血红蛋白 A1C(HbA1c)。HL 采用较好耳四个频率纯音平均≥26dB HL 定义,并根据世卫组织标准分级。使用 SPSS 进行统计分析。应用 χ²、独立 t 检验和多项逻辑回归分析。95%CI 置信区间的 P 值<0.05 被认为具有统计学意义。
我们的研究表明,T2DM 患者 SNHL 的患病率较高。轻度 HL 占 55.8%,中度 HL 占 18.7%。常见的听力障碍症状包括在嘈杂环境中理解言语困难(44.2%)、平衡问题(42.9%)、句子重复(35.9%)、耳鸣(32.3%)和辨别辅音(31.1%)。听力损伤主要影响低频(0.25-0.5 kHz)和高频(4-8 kHz),且在两性之间 4 kHz 时差异具有统计学意义 ( (394)=2.8, p=0.004)。在调整年龄、性别、体重指数和是否存在任何合并症后,多发性逻辑回归分析显示周围神经病变与 SNHL 显著相关。糖尿病病程、HbA1c 或糖尿病家族史与 SNHL 严重程度无关。
该研究强调了 T2DM 患者中 SNHL 的高患病率,并强调了作为糖尿病管理整体方法的一部分,进行针对性听力保健的重要性。早期治疗 HL 可能会显著改善沟通和整体生活质量。