Dysfunction of the peripheral and central auditory pathway in patients with type 1 diabetes mellitus


Although auditory alterations are not a typical symptom of diabetes mellitus (DM), they can occur in patients with type 1 DM. The findings of previous studies are controversial, because the frequency and degree of hearing loss varies, and quite often alterations are still subclinical. The typical test used to detect and manage hearing loss is the audiogram, but this test alone is only capable of detecting alterations due to injury of the inner hair cells and/or alterations in the central auditory pathway. However, auditory alterations resulting from a dysfunction that is still subclinical are only able to be detected through electrophysiological auditory tests, such as the otoacoustic emissions (OAE) and the auditory brainstem response (ABR) tests. Thus, the purpose of this paper is to review the studies that utilize the OAE and ABR tests, and to verify if the dysfunction is cochlear and/or neural in patients with type 1 DM. The findings of this review demonstrate that patients with type 1 DM can have auditory alterations stemming from a central cochlear origin. Following this finding, early diagnosis is very important in order to implement preventative treatments and initiate therapy.

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Fernandes, L. , Casais-Silva, L. and Ladeia, A. (2012) Dysfunction of the peripheral and central auditory pathway in patients with type 1 diabetes mellitus. Journal of Diabetes Mellitus, 2, 76-81. doi: 10.4236/jdm.2012.21012.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] American Diabetes Association (2010) Diagnosis and classification of diabetes mellitus. Diabetes Care, 33, S67-S69. doi:10.1186/1471-2458-11-564
[2] Hall, V., Thomsen, R., Henriksen, O. and Lohse, N. (2011) Diabetes in sub saharan Africa 1999-2011: Edpidemiology and public health implications—A systematic review. BMC Public Health, 11, 564.
[3] Tufano, A., Cimino, E., Di Minno, M.M.D., Ierano, P., Marrone, E., Strazzullo, A., Di Minno, G. and Cerbone, A.M. (2011) Diabetes mellitus and cardiovascular prevention: The role and the limitations of currently available antiplatelet drugs. International Journal of Vascular Medicine, 2011, 1-5.
[4] Brender, E., Burke, A.E. and Glass, R.M., (2006) Audiometry. Journal of the American Medical Association (JAMA), 295, 460. doi:10.1001/jama.295.4.460
[5] Lisowska, G., Namyslowski, G., Morawski, K. and Strojek K. (2001) Early identification of hearing impairment in patients with type 1 diabetes mellitus. Otology & Neurotology, 22, 316-320. doi:10.1097/00129492-200105000-00008
[6] Maia, C.A.S. and Campos, C.A.H. (2005) Diabetes mellitus como causa de perda auditiva. Revista Brasileira De Otorrinolaringologia, 71, 208-214.
[7] Kakarlapudi, V., Sawyer, R. and Staecker, H. (2003) The effect of diabetes on sensorioneural hearing loss. Otology & Neurotology, 24, 382-386. doi:10.1097/00129492-200305000-00006
[8] Kariya, S., Cureoglua, S., Fukushimad, H., Moritad, N., Baylanc, M.Y., Maedab, Y., Nishizakib, K. and Paparella, M.M. (2010) Comparing the cochlear spiral modiolar artery in type-1 and type-2 diabetes mellitus: A human temporal bone study. Acta Medica Okayama, 64, 375-383.
[9] Cullen, J.R. and Cinnamond, M.J. (1993) Hearing loss in diabetics. Journal of Laryngology & Otology, 107, 179-182.
[10] Celik, O., Yalcin, S., Celebi, H., Oztürk, A. (1996) Hearing loss in insulin-dependent diabetes mellitus. Auris Nasus Larynx, 23, 127-132.
[11] Bainbridge, K.E., Hoffman, H.J., Cowie, C. (2008) Diabetes and hearing impairment in the United States: Audiometric evidence from the national health and nutrition examination survey, 1999 to 2004. Annals of Internal Medicine, 149, 1-10.
[12] Elamin, A., Fadlallah, M., Tuevmo, T. (2005) Hearing loss in children with type 1 diabetes. Indian Pediatrics, 42, 15-21.
[13] Gawron, W., Pospiech, L., Noczynska, A. and Koziorowska, E. (2004) Sudden hearing loss as a first complication of long-standing Type 1 diabetes mellitus: a case report. Diabetic Medicine, 21, 96-98. doi:10.1046/j.1464-5491.2003.01067.x
[14] Kemp, D.T., Ryan, S. and Bray, P. (1990) A guide to the effective use of otoacustic emissions. Ear and Hearing, 11, 93-100. doi:10.1097/00003446-199004000-00004
[15] Ugur, A.K., Kemaloglu, Y.K., Ugur, M.B., Gunduz, B., Saridogan, C., Yesilkaya, E., Bideci, A., Cinaz, P. and Goksu, N. (2009) Otoacoustic emissions and effects of contralateral white noise stimulation on transient evoked otoacoustic emissions in diabetic children. International journal of Pediatric Otorhinolaryngology, 73, 555-559. doi:10.1016/j.ijporl.2008.12.002
[16] Lisowska, G., Namyslowski, G., Morawski, K., Strojek K. (2001) Cochlear dysfunction and diabetic microangiopath. Scandinavian Audiology, 30, 199-203.
[17] Fukushima, H., Cureoglu, S., Schachern, P.A., Kusunoki. T., Oktay, M.F., Fukushima, N., Paparella, M.M. and Harada, T. (2005) Cochlear changes in patients with type 1 diabetes mellitus. Otolaryngology—Head and Neck Surgery, 133, 100-106. doi:10.1016/j.otohns.2005.02.004
[18] Erdem, T., Ozturan, O., Miman, M.C., Ozturk, C. and Karatas, E. (2003) Explorations of the early auditory effects of hyperlipoproteinemia and diabetes mellitus using otoacustics emissions. European Archives of Otorhinolaryngology, 260, 62-66.
[19] Fernandes, L.C. and Santos-Momensohn, T.M. (2009) Tinnitus and normal hearing: A study on the transient otoacoustic emissions suppression. Brazilian Journal of Otorhinolaryngology, 75, 414-419. doi:10.1590/S1808-86942009000300017
[20] Pudar, G., Vlaski, L., Filipovic, D. and Tanackov, I. (2009) Correlation of hearing function findings in patients suffering from diabetes mellitus type 1 in regard to age and gender. Medicinski Pregled, 62, 395-401. doi:10.2298/MPNS0910395P
[21] Park, M.S., Park, S.W. and Choi, J.H. (2001) Distortion product otoacoustic emissions in diabetics with normal hearing. Scandinavian Audiology, 30, 148-115. doi:10.1080/010503901300007362
[22] Di Nardo, W., Ghirlanda, G., Paludetti, G., Cercone, S., Saponara, C., Del Ninno, M., Girolamo S.D., Magnani, P. and Di Leo, M.A.S. (1998) Distortion-Product otoacoustic emissions and selective sensorineural loss in IDDM. Diabetes Care, 21, 1317-1321. doi:10.2337/diacare.21.8.1317
[23] Alborch, M.O., Morant, V.A., García, C.J., Pérez, D.V.B., Lorente, R. and Marco A.J. (1998) The study of otoacoustic emissions in diabetes mellitus. Acta Otorrinolaringology, 49, 25-28.
[24] Di Leo M.A.S., Di Nardo, W., Cercone, S., Ciervo, A., Lo Monaco, M., Greco, A.V., Paludetti, G. and Ghirlanda, G.L. (1997) Cochlear Dysfunction in IDDM Patients with Subclinical Peripheral Neuropathy. Diabetes Care, 20, 824-828. doi:10.2337/diacare.20.5.824
[25] Dabrowski, M., Mielnik-Niedzielska, G. and Nowakowski, A. (2011) Involvement of the auditory organ in type 1 diabetes mellitus. Journal of Endocrinology, 62, 138-144.
[26] Ottaviani, F., Dozio, N., Neglia, C.B., Riccio, S. and Scavini, M. (2002) Absence of otoacoustic emissions in insulin-dependent diabetic patients. Is there evidence for diabetic cochleopathy? Journal of Diabetes and Its Complications, 16, 338-343. doi:10.1016/S1056-8727(01)00224-0
[27] Seidl, R., Birnbacker, R., Hauser, E., Bernert, G., Freilinger, M. and Schober, E. (1996) Brainstem Auditory Evoked Potentials and Visually Evoked Potentials in Young Patients with IDDM. Diabetes Care, 19, 1220-1224. doi:10.2337/diacare.19.11.1220
[28] Tóth, F., Várkonyi, T.T., Rovó, L., Lengyel, C., Légrády, P., Jóri, J., Czigner, J. and Kiss, J.G. (2003) Investigation of auditory brainstem function in diabetic patients. International Tinnitus Journal, 9, 84-86.
[29] Durmus, C., Vetiser, S. and Durmus, O. (2004) Auditory brainstem evoked responses in insulindependent (ID) and non-insulin-dependent (NID) diabetic subjects with normal hearing. International Journal of Audiology, 43, 29-33. doi:10.1080/14992020400050005
[30] Niedzielska, G. and Katska, E. (1998) ABR disturbances in children with insulin dependent diabetes mellitus. International Journal of Pediatric Otorhinolaryngology, 44, 1-4. doi:10.1016/S0165-5876(98)00017-2
[31] Pessin, A.B.B, Martins, R.H.G., Pimenta, W.P., Simoes, A.C.P., Marsiglia, A. and Amaral, A. (2008) Auditory evaluation in patients with type 1 diabetes. The Annals of Otology, Rhinology & Laryngology, 117, 366-370.
[32] McCrimmon, R.J., Deary, I.J. and Frier, B.M. (1997) Auditory information processing during acute insulin-induced hypoglycaemia in non-diabetic human subjects. Neuropsychology, 35, 1547-1553.
[33] Hannoen, R., Tupola, S., Ahonen, T. and Riikonen, R. (2003) Neurocognitive functioning in children with type-1 diabetes with and without episodes of severe hypoglycaemia. Developmental Medicine & Child Neurology, 45, 262-268. doi:10.1111/j.1469-8749.2003.tb00341.x
[34] McAulay, V., Deary, I.J., Sommerfield, A.J. and Frier, B.M. (2006) Attentional functioning is impaired during acute hypoglycaemia in people with Type 1 diabetes. Diab Medical, 1, 26-31. doi:10.1111/j.1464-5491.2005.01795.x
[35] Strachan, M.W.J., Ewing, F.M.E., Frier, B.M., Mccrimmon, R.J. and Deary, I.J. (2003) Effects of acute hipoglycaemia on auditory information processing in adults with type I. Diabetology, 46, 97-105.
[36] Cooray, G.K., Maurex, L. and Brismar, T. (2008) Cognitive impairment correlates to low auditory event-related potential amplitudes in type 1 diabetes. Psychoneuroendocrinology, 33, 942-950. doi:10.1016/j.psyneuen.2008.04.013

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