Researchers led by a team in Brisbane have suggested that adults with type 2 diabetes are more than twice as likely to develop clinically significant hearing loss as those without diabetes – and that as many as one in four people with this form of diabetes already have a serious hearing impairment, reports Medical News Today.
Their findings are based on a review of 29 studies involving more than 17 000 participants, and although it could not establish that diabetes directly causes hearing loss, the study authors recommend that routine hearing tests be incorporated into standard diabetes care to help identify potential hearing problems earlier.
While people with diabetes are routinely monitored for conditions like diabetic retinopathy, kidney disease and neuropathy, which can help prevent severe problems such as sight loss, kidney damage and nerve damage, the new review suggests hearing loss could be an under-recognised complication, with many people unaware that the condition may affect hearing.
The findings, published in Diabetes Metabolism Research and Reviews, analysed data from 29 observational studies (between 2000 and 2025) involving more than 17 000 people worldwide, which assessed hearing using standard audiometric tests in adults with type 2 diabetes or prediabetes.
Overall, the review found that clinically significant hearing loss was common among people with diabetes.
Lead study author Mehwish Nisar, MD, PhD, AFHEA, a Postdoctoral Research Fellow and Affiliate of the University of Queensland Centre for Hearing Research (CHEAR), told MNT: “Retinopathy, nephropathy and neuropathy are complications with established, formalised screening pathways in diabetes care, so they’re front of mind for clinicians and patients alike.
“But hearing loss has never been systematically built into those care protocols, so it’s essentially fallen through the cracks – not because the biological link isn’t real, but because it hasn’t been prioritised or measured with the same rigour.”
She said part of what motivated the review was that previous studies lumped together all severities of hearing loss, including very mild, subclinical changes, ”which may have understated how much of this burden is actually clinically significant and disabling”, she added.
What the review found
Across 23 studies involving more than 5 200 people with diabetes, the researchers found that around one in four people had moderate-to-severe hearing loss.
Based on estimates from the WHO, this suggests that hundreds of millions of people globally may have serious hearing impairment as a complication of diabetes.
When they compared data from 11 studies that included those with and without diabetes, the study team found that people with diabetes were more than twice as likely to have clinically significant hearing loss.
They also looked at whether some groups were more likely to experience hearing loss than others.
They found the link between diabetes and hearing loss was strongest in adults under 60, who were around three times more likely to have moderate-to-severe hearing loss than people of the same age without diabetes.
The increased risk was also seen in those who had been living with diabetes for less than 10 years, suggesting hearing problems may develop earlier than previously thought.
The association was also stronger in studies from low- and middle-income countries, although the researchers said more research is necessary to understand why.
They also noted differences between the studies, including the types of participants involved and the methods used to measure hearing. Despite these differences, the overall findings remained consistent.
However, because the review included observational studies, it cannot show that diabetes directly causes hearing loss; it can only show that the two are linked.
“One in four adults with diabetes has hearing loss serious enough to struggle in everyday conversation – the kind that needs hearing aids. Yet it is not on doctors’ checklists. This is a similar scale of burden to complications like retinopathy or nephropathy, which are already routinely screened for, yet hearing is not,” said Nisar.
“People with diabetes shouldn’t wait until hearing loss is advanced or assume it’s just ‘getting older’ – it’s worth asking their care team about a hearing check, particularly if they’re under 60 or have had diabetes for even a relatively short time.”
Why might diabetes affect hearing?
Although the review did not investigate the possible biological mechanisms behind the association, previous research has suggested several potential explanations.
The US Centres for Disease Control and Prevention (CDC) also suggests hearing loss is twice as common in people with diabetes as it is in those without, with prediabetics also having a 30% higher rate of hearing loss.
Similar to how retinopathy or neuropathy may develop with diabetes, persistently high blood glucose levels may damage small blood vessels and delicate structures of the inner ear, as well as reduce blood flow to the ear, which could affect hearing over time.
However, more research is still necessary to understand exactly how diabetes may influence hearing health.
“Chronic high blood glucose damages the small blood vessels and nerves supplying the cochlea (the inner ear), in much the same way it damages the retina, kidneys, and peripheral nerves,” Nisar said. “This includes microangiopathy (small vessel damage), oxidative stress, and neuropathy affecting the auditory nerve pathways.
“Over time this cumulative cochlear damage impairs the ear’s ability to detect sound, particularly at higher frequencies, and it can progress silently, since people often don’t notice gradual hearing decline until it starts affecting daily communication.”
Complications typically become more likely the longer a person has had diabetes. In addition to a longer duration of diabetes, increasing age is also a common risk factor for hearing loss.
However, the review found that the increased risk of hearing loss was still present among those who’ve had diabetes for under 10 years, suggesting that hearing changes may begin earlier than previously thought, and that it may also be advisable for earlier screening, too.
Study limitations
While the analysis highlights a consistent association between diabetes and hearing loss, the findings are based on a review of previously published studies, and not a new clinical trial. Thus, it cannot prove that diabetes directly causes hearing impairment.
Although the results suggest that diabetes may contribute, it is also important to consider other factors may relate to hearing loss, like age, cardiovascular disease, noise exposure, smoking, and certain medications.
The researchers note that further prospective studies are necessary to clarify the relationship and determine whether routine hearing screening improves long-term outcomes for people living with diabetes.
Still, the review adds to growing evidence that hearing health may deserve greater attention in diabetes care.
Study details
Hearing loss in adults with diabetes and prediabetes: a systematic review and meta-analysis
Mehwish Nisar, Shamshad Karatela, Anjana Rajagopal et al.
Published in Diabetes Metabolism Research and Reviews on 23 June 2026
Abstract
Diabetes impairs hearing through microvascular damage and neuropathy, yet the prevalence of moderate-to-severe hearing loss (≥ 40 dB HL) remains inadequately explored. Variations by age, diabetes duration, and socioeconomic factors are inadequately characterised. This systematic review quantified the prevalence and comparative risk of moderate-to-severe hearing loss in diabetes and prediabetes, exploring variations across age, national income level, and disease duration. We searched PubMed, Scopus, Web of Science, SPORTDiscus, and CINAHL (2000–2025) for observational studies reporting audiometric thresholds in diabetic or prediabetic subjects (PROSPERO: CRD42018100742). Quality was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analyses generated pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was evaluated via funnel plots and Egger’s regression. Of 3490 records, 29 studies qualified. Most examined type 2 diabetes; one included prediabetes. Twenty-three studies (n = 5221) yielded a pooled prevalence of 24% (95% CI: 19%–30%; I2 = 94%). Eleven studies showed diabetes doubled hearing loss odds versus controls (OR = 2.41, 95% CI: 1.62–3.60; I2 = 86.6%). Risk was significantly elevated in younger adults (< 60 years: OR = 3.03, 95% CI: 2.17–4.22) but not in older adults (≥ 60 years: OR = 1.52, 95% CI: 0.72–3.22). Low- and middle-income countries showed the highest risk (OR = 4.51, 95% CI: 2.43–8.40) versus high-income countries (OR = 1.78, 95% CI: 1.05–3.02). Diabetes duration < 10 years conferred elevated risk (OR = 2.68). Small-study effects were detected (Egger’s p = 0.019) but sensitivity analyses confirmed robustness. One in four diabetic adults has clinically significant hearing loss, particularly in younger individuals and resource-limited populations. These findings support the integration of routine audiometric screening into diabetes care.
See more from MedicalBrief archives:
Hearing aid before the age of 70 cuts dementia risk – US study
Half of those with diabetes don’t know they have it – US study
Cochlear implants for adults should be recommended more often