Abstract
Peripheral neuropathy is a major consequence of diabetes mellitus with up to 50 % of patients showing clinically significant neural injury during the disease course. Hearing loss (as defined by impaired sound detection thresholds) is a recognized symptom of DM, but the possibility of auditory neuropathy (AN) has not been explored in this population. This pilot study investigated peripheral auditory function, auditory processing and speech perception in individuals with Type 1 diabetes mellitus (T1DM) and compared the findings with measures of vestibular function, ocular pathology/visual acuity and overall neurologic profile. Ten adults with T1DM and ten matched controls underwent a battery of tests which included: audiometry, otoacoustic emissions, auditory brainstem responses, temporal processing measures and speech perception. Six of the ten T1DM participants showed electrophysiologic evidence of AN and impaired functional hearing. Furthermore, auditory capacity was correlated with both visual acuity and degree of somatic peripheral neuropathy. This pilot investigation revealed functional-hearing deficits severe enough to impact upon everyday communication. Should the findings be confirmed by larger studies, auditory evaluation may form an important part of the management regimen for individuals with T1DM. This may be especially important for those with DM-related eye conditions, as deficits across multiple sensory modalities can have multiplicative detrimental effects on quality-of-life.
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References
Maser RE, Steenkiste AR, Dorman JS et al (1989) Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes 38:1456–1461
Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL (2012) Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 11(6):521–534
Lisowska G, Namyslowski G, Morawski K, Strojek K (2001) Early identification of hearing impairment in patients with type 1 diabetes mellitus. Otol Neurotol 22(3):316–320
Horikawa C, Kodama S, Tanaka S et al (2013) Diabetes and risk of hearing impairment in adults: a meta-analysis. J Clin Endocrinol 98:51–58
Smith TL, Raynor E, Prazima J, Buenting JE, Pillsbury HC (1995) Insulin-dependent diabetic microangiopathy in the inner ear. Laryngoscope 105(3):236–240
Jorgensen MB (1961) The inner ear in diabetes mellitus. Histological studies. Arch Otolaryngol 74:373–381
Makishima K, Tanaka K (1971) Pathological changes of the inner ear and central auditory pathway in diabetics. Ann Otol Rhinol Laryngol 80(2):218–228
Starr A, Picton TW, Sininger YS, Hood LJ, Berlin CI (1996) Auditory neuropathy. Brain 119(3):741–753
Rance G, Fava R, Baldock H et al (2008) Speech perception ability in individuals with Friedreich ataxia. Brain 131:2002–2012
Rance G, Ryan MM, Bayliss K, Gill K, O’Sullivan C, Whitechurch M (2012) Auditory function in children with Charcot–Marie–Tooth disease. Brain 135:1412–1422
Zeng F-G, Kong Y-Y, Michaelewski HJ, Starr A (2005) Perceptual consequences of disrupted auditory nerve activity. J Neurophysiol 93:3050–3063
Rance G, O’Hare F, O’Leary S et al (2012) Auditory processing deficits in individuals with primary open angle glaucoma—evidence for neuronal susceptibility outside the visual pathways. Int J Audiol 51(1):10–15
Fowler C, Noffsinger D (1983) Effects of stimulus repetition rate and frequency on the auditory brainstem response in normal, cochlear-impaired and VIII nerve/brainstem-impaired subjects. J Speech Hear Res 26:560–567
Poretti A, Palla A, Tarnutzer AA et al (2013) Vestibular impairment in patients with Charcot–Marie–Tooth disease. Neurology 80(3):2099–2105
Chia EM, Mitchell P, Rochtchina E et al (2006) Association between vision and hearing impairments and their combined effects on quality of life. Arch Opthalmol 124(10):1465–1470
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This work was supported by a Diabetes Australia Research Trust (DART) Project Grant.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Rance, G., Chisari, D., O’Hare, F. et al. Auditory neuropathy in individuals with Type 1 diabetes. J Neurol 261, 1531–1536 (2014). https://doi.org/10.1007/s00415-014-7371-2
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DOI: https://doi.org/10.1007/s00415-014-7371-2