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Particular causes of hearing loss will be show up in the clinical audiogram in characteristic ways.
Conductive hearing loss comes about when the transmission of sound to the inner ear is impaired, perhaps due to impacted ear wax (cerum), an ear infection (otitis media with effusion or OME), or calcification of the middle ear ossicles (otosclerosis).
It is often possible to treat conductive hearing loss by removing the cause of the physical obstruction. By far the most common cause of sensory neural hearing loss is damage to sensory hair cells in the cochlea.
Because our outer and middle ear transmits frequencies near 4 kHz very efficiently, hair cells that are tuned to frequencies near 4 kHz are particularly vulnerable to noise damage.
Even if we avoid exposure to very loud noise, the ear's outer hair cells may also simply wear out as we age, leading to age related hearing loss.
For the last 17 years, I've traveled to over 40 countries, and every continent, as an audiologist conducting presentations and training on audiology and hearing instruments for a major manufacturer.
Since diabetes is a systemic disease that affects multiple organ systems, it is reasonable to inquire if the auditory system is among those affected.  Although there has been evidence since the mid-19th century linking diabetes with hearing loss, controversy has surrounded this association. Only the Epidemiology of Hearing Loss Study, a community-based investigation conducted in Beaver Dam, Wisconsin, detected a modest increase in occurrence of hearing impairment among adults with diabetes compared to those without diabetes. Conflicting evidence has prevented diabetes-related hearing impairment from receiving much attention among research scientists and much acceptance among health care professionals.  Recently, though, research findings suggest that impaired hearing is not only very common among older and middle-aged people with diabetes, but that hearing loss also affects young people with diabetes more than those with normal hearing. A recent study by a Japanese team, Horikawa, et al (2013) found that, in general, diabetics were 2.15 times more likely to have hearing loss than people without the disease.
1.  Low HDL or high-density lipoprotein cholesterol, coronary heart disease, peripheral neuropathy, and having poor health are potentially preventable correlates of hearing impairment for people with diabetes.


2.  Some degree of hearing impairment affects over two-thirds of diabetic adults, about twofold higher than that of the non-diabetic population. 3.  Data that would have provided evidence that diabetes severity is associated with the likelihood of hearing impairment was inconclusive. Hearing impairment is not widely recognized as a complication of diabetes despite its occurrence in as many as two-thirds of our diabetic sample. While some of the diabetes related hearing impairment can be prevented, these data suggest that all diabetics should have their hearing screened to determine if their disease affects their hearing is compromised by the disorder.  As audiologists we need to encourage physicians worldwide to refer patients with diabetes for hearing evaluations to rule out a related hearing impairment. Conductive hearing loss tends to a loss of sensitivity across the entire range of frequencies, most commonly in one ear only.
In this condition, high frequency outer hair cells tend to die off before low-frequency ones, possibly because the high frequency outer hair cells have to work harder if their job is to amplify acoustic vibrations on a cycle by cycle basis. I've learned that audiologists the world over, while a diverse group, share the same goals and objectives for our patients. Also, the risk of a stroke or fatal cardiac event is two to four times higher among adults with diabetes than those without diabetes.
Early attempts to establish an association between diabetes and hearing impairment were not very convincing, probably due to subject selection, design or other errors.
The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. I invite guest articles on topics ranging from differences in training, expertise, and scope of practice from one country to another to interesting, debonair, or disgusting practices. Altogether, the data covered 7,377 diabetics and 12,817 people without the condition.  Some scientists, however, caution that this kind of study does not prove that diabetes is directly responsible for the greater rate of hearing loss among those with the disease.


Figure C suggests the difference in hearing for those with peripheral neuropathy, with the peripheral neuropathy patients having the worse of the two audiograms presented.  Finally Figure D presents the healthiness of the patients, with those in poor health having worse hearing. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men since men do not live as long. Stories of travel, clinical practice, research, training diversity and other topics are of particular interest. It found a higher threshold among diabetic persons only at 500 Hz (Ma, Gomez-Marin, Lee, & Balkany, 1998).
Diabetic subjects with low HDL, a history of coronary heart disease, symptoms of peripheral neuropathy, or those who report poor health also exhibited a greater likelihood of hearing impairment. Noise damage or age related hearing loss tends to produce characteristic deficits as shown in the audiograms here below. Severe forms of diabetic nerve disease often necessitate amputation of the lower extremities.
Unlike conductive hearing loss, which can often be cured, sensory-neural hearing loss is in most cases irreparable, and treatment will aim to make the best use of those auditory structures that remain in tact, perhaps by boosting sensitivity through a hearing aid, or, in severe cases, by trying to bypass dead sensory hair cells with cochlear or brainstem implants. Diabetic autonomic neuropathies can affect cardiovascular, gastrointestinal, bladder, and erectile function.
Given the increasing prevalence of obesity, however,  it is likely that these figures provide an underestimate of future diabetes prevalence.



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10.08.2015 admin



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