If you have diabetes, you likely know that frequent eye examinations are important because diabetes can cause vision loss. But did you know that diabetes can also affect your hearing? According to the National Institutes of Health, hearing loss among people with diabetes is an under-recognized problem although it’s up to twice as common among people with diabetes than those who don’t have the disease. In addition, people with pre-diabetes, those who have high blood glucose (sugar) but not high enough to be diagnosed with diabetes, are up to 30% more likely to have hearing loss. How can diabetes affect your hearing? If you have diabetes, your blood glucose levels are too high. With type 1 diabetes, your pancreas can’t produce the insulin your body needs and with type 2 diabetes, your pancreas does produce some insulin, but either it doesn’t produce enough or your body doesn’t use it effectively. Consistently high levels of blood glucose can damage your blood vessels, resulting in less oxygen transported to sensitive tissues. It can happen anywhere in your body, such as your eyes, causing diabetic retinopathy, a condition that causes blindness when the tiny blood vessels in the back of the eye become damaged. High blood glucose can also cause damage to your nerves over time, resulting in a condition called diabetic neuropathy. While researchers don’t know yet why people with diabetes may develop hearing loss, they suspect the cause may be similar to what causes diabetic retinopathy, or perhaps by damage to the nerves that help transmit sound from the ear to the brain. Is the hearing loss sudden or gradual? Sudden hearing loss isn’t common. When it does happen, it’s usually only on one side, perhaps caused by an infection or trauma to the ear. Hearing loss caused by diabetes typically comes on gradually and may not be noticeable at first. It’s possible that you don’t notice it until other people comment on it. Some signs of hearing loss may include: Not being able to make out what people are saying when there is background noise, like at a party or in a restaurant Asking others to repeat themselves frequently Thinking that people are mumbling or talking at low levels Having the feeling that sounds and speech are muffled Turning up the volume on the TV or radio to the point that others say it is too loud How can I reduce my risk of hearing loss from diabetes? You may reduce the risk of developing hearing loss caused by diabetes by monitoring and keeping your blood glucose as close to your target goal as possible. Speak with your doctor or diabetes nurse if you are having trouble stabilizing your blood glucose with your current treatment plan. Managing your diabetes may include: Taking oral medications (pills) or insulin Testing your blood glucose regularly Eating a healthy diet, limiting intake of food and drink that will increase your blood glucose levels Exercising regularly Reducing stress Getting the recommended amount of sleep Stopping smoking if you smoke Limiting your alcohol consumption You can also help preserve your hearing by taking other general precautions, such as: Wearing earplugs if you work in a noisy environment – check the packaging to see the level of noise the earplugs are designed to block. Wearing hearing protection if participating in recreational activities that have loud noise – either continuous, such as a music concert, or sudden bursts of sound, such as gun fire. Having regular hearing tests if you are exposed to high levels of noise. Living with diabetes can be challenging, but by working with your diabetes care team to come up with a diabetes treatment plan, you can reduce your risk of complications that may be caused by the disease.