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From New Orleans, Louisiana, USA:

I am 18 years old and was diagnosed with typeá1 diabetes a little over two years ago. About a month ago, I was in a car accident and lost a substantial amount of hearing in my ears. Before that, I was having ear infections extremely often. Could that have any connection to my diabetes?


Ear infections are often seen in people without diabetes. From my personal experience, I have not seen an increase in patients with diabetes having ear infections.

In terms of losing hearing after a car accident: There are three types of hearing loss:

  1. A conductive loss -- The sound waves are physically blocked from the outer ear to the inner ear. After a head trauma, there may be blood in the middle ear blocking the sound, or the ear bones (ossicles) may be fractured, or there may be a hole in the eardrum (tympanic membrane perforation).
  2. A sensorineural loss -- The sound gets to the inner ear, but the cochlear malfunctions and cannot transform the sound waves into nerve waves or the nerve is "broken" and can not transmit the nerve wave to the brain, or even a malfunction in the brain stem/central nervous system, the area where the nerve "waves" are processed in the brain. During a head trauma, these areas can be shaken up and a "concussion" may occur, altering these areas. A cochlear concussion may return in function.
  3. A mixed hearing loss -- Made up of problems 1 and 2.
I suggest you see an ear nose and throat specialist, and get your ears checked out, and a hearing test.

A general recommendation, for everyone, is to avoid acoustic trauma, to allow for maximal acoustic preservation. Excessive exposure to loud noise can cause damage to delicate hair cells in the ear, and cause sensorineural hearing loss. This is especially significant for people with diabetes, who are at risk for blindness from retinopathy, etc., and will need to maximize their other incoming sensory stimulations, especially hearing, to maximize communications, functioning, etc. See Noise, Ears & Hearing Protection. You can do the "5 minute hearing test" on-line.

Problems that people with diabetes get in regard to their hearing in general are microangiopathy, and a development of a sensorineural hearing loss. See: Diabetes Increases the Prevalence of Sensorineural Hearing Loss and Diabetes and Hearing loss.

There are also rare forms of diabetes and deafness. See:

  1. a previous question on this topic
  2. Early identification of hearing impairment in patients with type 1 diabetes mellitus.
  3. Maternally inherited diabetes and deafness: a multicenter study
  4. UKPDS 21: low prevalence of the mitochondrial transfer RNA gene (tRNA(Leu(UUR))) mutation at position 3243bp in UK Caucasian type 2 diabetic patients..
  5. Syndrome of optic nerve atrophy, diabetes mellitus and diabetes insipidus.
  6. Distortion product otoacoustic emissions in diabetics with normal hearing.
  7. Cochlear dysfunction and diabetic microangiopathy..

Finally, there is an entity called malignant otitis externa, which more often affects people with diabetes. This is an infection of the outer ear canal, which penetrates the cartilage of the ear canal and invades the bone, causing a skull bone infection. In the past, it was often fatal (hence the term "malignant"). With new treatments, it is often treatable and preventable in the outpatient stages. The symptom of this is ear pain and drainage that does not resolve with normal antibiotics. The diagnosis is made by CT scan or with a bone scan. Resolution of the infection is made with a gallium scan (looking for radio-labeled white blood cells. If they are still congregating in the bone, the infection is still there). This infection is rare, and I have seen it only a couple of times in my life.


Original posting 1 Aug 2001
Posted to Complications


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Last Updated: Tuesday April 06, 2010 15:09:24
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