Diabetes and Subjective Tinnitus

Subjective tinnitus is the form of “ringing in the ears” that can only be heard by the person who has it. While the most common type of tinnitus, it is also the one for which one specific cause can rarely be identified.  That’s because subjective tinnitus is a symptom of numerous ear disorders and other medical conditions, including vascular disorders, glucose metabolic problems, and diabetes.

Contributing factors to tinnitus in diabetics

Approximately 30 million people in the U.S. alone have a form of diabetes, a group of diseases that affect your body’s ability to properly use an excess amount of glucose (sugar) in your bloodstream.  Of these, an estimated 34.5 million also have some type of hearing loss, which is twice as common in diabetics as in people without the disease. While hearing loss and tinnitus occur independently of one another, in many cases the root cause of one also leads to the other.

Three potential triggers for hearing damage and subjective tinnitus in people with diabetes include the following:

  • Inadequate blood flow, a known complication of diabetes. When blood sugar increases, it thickens your blood and makes it very difficult to pass through the tiny capillaries of your cochlea (inner ear). This restricted blood flow damages and eventually destroys the fragile stereocilia (hair cells) that conduct sound from your cochlea to your auditory cortex for processing. The more of them you lose, the less you’re able to hear and process external sounds properly.
  • Exposure to high blood sugar over a long time can damage the eighth cranial nerve, which is responsible for transmitting sound and balance information from your inner ear to the brain.
  • Even slightly elevated blood sugar over time can interfere with the enzyme known as the ATPase pump, which creates the optimal potassium and sodium concentrations for inner ear fluid. This is also necessary for balance and good hearing.

What you can do to protect your hearing

Whether you’re pre-diabetic or have Type 1 or Type 2 diabetes, your physician can help you find ways to lower and control your blood sugar, usually with a combination of dietary and lifestyle changes, combined with medications like Metformin or insulin if necessary. Additionally, you should avoid other known contributors to tinnitus, such as excessive or frequent exposure to loud noises, smoking, and intake of other ototoxic (poisonous to the ear) substances and medications. We encourage you to involve a hearing care professional in your diabetes treatment plan to assist you with any hearing difficulties that may arise, especially if you require treatment of any hearing loss or tinnitus that develops with hearing aids.