Diabetes and Hearing Loss

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Contact Dr. Dowd at www.hearingsolutioncenter.com with questions.

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  • With all these vessels, hard to imagine the ear escaping the ravages of diabetes!
  • 1927 Alport described hearing loss associated with familial kidney disease. Reference article: American Journal of Kidney Diseases (2010:56:661-669)
  • Diabetes and Hearing Loss

    1. 1. Diabetes and Hearing Loss by Kathryn Dowd, AuD Clinical Audiologist Hearing Solution Center Charlotte, NC www.hearingsolutioncenter.com
    2. 2. Purpose of Presentation <ul><li>To make health care providers in NC aware of the link of diabetes to hearing loss and the need for intervention: </li></ul><ul><ul><li>Why hearing loss occurs with diabetes </li></ul></ul><ul><ul><li>What is the impact of hearing loss on quality of life issues </li></ul></ul><ul><ul><li>What are the recommendations for diabetes education in light of hearing loss </li></ul></ul>
    3. 3. Medical Conditions with Secondary Hearing Loss <ul><li>A. Diabetes </li></ul><ul><li>B. Hypothyroidism </li></ul><ul><li>C. Multiple sclerosis </li></ul><ul><li>D. Chronic Renal Disease </li></ul><ul><li>E. Alport’s Syndrome </li></ul><ul><li>F. Paget’s Disease </li></ul><ul><li>G. Cogan’s Syndrome </li></ul><ul><li>H. Other Medical conditions </li></ul>
    4. 4. Ototoxic Drugs <ul><li>A. Aminoglycoside Antibiotics (mycin drugs) </li></ul><ul><li>B. Loop Inhibiting Diuretics (lasix, furosemide) </li></ul><ul><li>C. Salicylates (aspirin, darvon, darvocet) </li></ul><ul><li>D. Cancer Chemotherapy </li></ul><ul><li>E. Quinine </li></ul>
    5. 5. Diabetes and hearing loss <ul><li>In people age 60 and older with type 2 diabetes: </li></ul><ul><ul><li>High blood sugar causes tiny blood vessels in the inner ear to break, disrupting sound reception. </li></ul></ul><ul><ul><li>Associated balance problems may come from neuropathy </li></ul></ul>
    6. 6. VASCULATURE OF THE EAR <ul><li>Blood Vessels of the Inner Ear </li></ul><ul><li>Arteries of the Middle Ear </li></ul>
    7. 7. CHRONIC KIDNEY DISEASE & HEARING LOSS <ul><li>Association of CKD & Hearing Loss Known for Decades </li></ul><ul><li>Kidney & Stria Vascularis of Cochlea Share Physiologic, Ultrastructural and Antigenic Similarities </li></ul><ul><li>Diabetes Often Results in Chronic Renal Disease </li></ul><ul><li>Therefore, the Link Between Diabetes and Hearing Loss May Be Indirect But Exists </li></ul>
    8. 8. MALIGNANT OTITIS EXTERNA <ul><li>Osteomyelitis of the Ear Canal </li></ul><ul><li>Often Involves the Adjacent Mastoid Bone </li></ul><ul><li>Pseudomonas is Common </li></ul><ul><li>Necrosis or Granulation of Canal </li></ul><ul><li>Exquisitely Tender to Motion </li></ul><ul><li>Temp Often >39˚ C (102.2˚) </li></ul><ul><li>May Find Facial Paralysis, Vertigo or Meningeal Signs </li></ul><ul><li>Intervention : </li></ul><ul><li>-- Incision & Drainage/Culture </li></ul><ul><li>--Ototopical & Oral Antibiotics </li></ul><ul><li>--Possible IV Therapy In-Patient </li></ul><ul><li>Diabetics at Increased Risk  Urgent Referral </li></ul><ul><li>Malignant External Otitis  Pus Draining from Necrotic Ear Canal & Underlying Osteomyelitic Bone; Swelling of Auricle With Loss of Cartilaginous Architecture </li></ul>
    9. 9. Effects of Untreated Hearing Loss <ul><li>embarrassment, fatigue, irritability </li></ul><ul><li>tension/stress </li></ul><ul><li>avoidance of social activities </li></ul><ul><li>withdrawal from personal relationships </li></ul><ul><li>depression, negativism </li></ul><ul><li>danger to personal safety </li></ul><ul><li>social rejection by others </li></ul><ul><li>impaired memory and ability to learn new tasks </li></ul><ul><li>Reduced job performance and earning power </li></ul><ul><li>Diminished psychological and overall health </li></ul><ul><li>(Better Hearing Institute, 2009) </li></ul>
    10. 10. Auditory Deprivation <ul><li>Although we hear with our ears, it is the brain that is the true hearing organ </li></ul><ul><li>Over time, the brain’s ability to understand speech is often affected by hearing loss </li></ul><ul><li>Once the ability to understand is lost, that ability can be difficult, if not impossible, to regain </li></ul><ul><li>Wearing hearing instruments can assist the brain in keeping the ability to understand from being lost </li></ul>
    11. 11. Recommendations for Monitoring Hearing <ul><li>Screen hearing when identified with Diabetes </li></ul><ul><li>Ongoing assessment of hearing levels at least once a year </li></ul><ul><li>Encourage use of hearing aids if recommended </li></ul><ul><li>Seek an audiologist for comprehensive hearing services </li></ul>
    12. 12. Improved Hearing Means: <ul><li>Better family relationships and communication </li></ul><ul><ul><li>Less isolation and less prone to depression </li></ul></ul><ul><li>Better job performance </li></ul><ul><li>More energy/less stress </li></ul><ul><li>Better quality of life: involvement in church, family and group activities </li></ul>
    13. 13. NC Diabetes State Plan <ul><li>Clinical Interventions </li></ul><ul><ul><li>“ Improve screening for and management of diabetes by encouraging healthcare providers to follow ADA guidelines, and include oral health and auditory screening as part of baseline assessments for people with diabetes.” </li></ul></ul><ul><li>Counseling and Education </li></ul><ul><ul><li>“ Raise awareness about diabetes uncommon co-morbidities including hearing loss and sleep apnea.” </li></ul></ul>
    14. 14. Resources for Hearing Services <ul><li>NC American Academy of Audiology </li></ul><ul><li>Better Hearing Institute www.betterhearing.org </li></ul><ul><li>NC Technical Equipment Program </li></ul><ul><li>Easter Seals www.eastersealsucp.com </li></ul><ul><li>Community Alternatives Program (CAP) </li></ul><ul><li>NC Vocational Rehabilitation </li></ul><ul><ul><li>Independent Living </li></ul></ul>
    15. 15. Questions? Kathryn Dowd, AuD Clinical Audiologist Hearing Solution Center Charlotte, NC www.hearingsolutioncenter.com

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