Abstract / Summary
Diabetes impairs hearing through microvascular damage and neuropathy, yet the prevalence of moderate-to-severe hearing loss (≥ 40 dB HL) remains inadequately explored. Variations by age, diabetes duration, and socioeconomic factors are inadequately characterised. This systematic review quantified the prevalence and comparative risk of moderate-to-severe hearing loss in diabetes and prediabetes, exploring variations across age, national income level, and disease duration. We searched PubMed, Scopus, Web of Science, SPORTDiscus, and CINAHL (2000-2025) for observational studies reporting audiometric thresholds in diabetic or prediabetic subjects (PROSPERO: CRD42018100742). Quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses generated pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was evaluated via funnel plots and Egger's regression. Of 3490 records, 29 studies qualified. Most examined type 2 diabetes; one included prediabetes. Twenty-three studies (n = 5221) yielded a pooled prevalence of 24% (95% CI: 19%-30%; I2 = 94%). Eleven studies showed diabetes doubled hearing loss odds versus controls (OR = 2.41, 95% CI: 1.62-3.60; I2 = 86.6%). Risk was significantly elevated in younger adults (< 60 years: OR = 3.03, 95% CI: 2.17-4.22) but not in older adults (≥ 60 years: OR = 1.52, 95% CI: 0.72-3.22). Low- and middle-income countries showed the highest risk (OR = 4.51, 95% CI: 2.43-8.40) versus high-income countries (OR = 1.78, 95% CI: 1.05-3.02). Diabetes duration < 10 years conferred elevated risk (OR = 2.68). Small-study effects were detected (Egger's p = 0.019) but sensitivity analyses confirmed robustness. One in four diabetic adults has clinically significant hearing loss, particularly in younger individuals and resource-limited populations. These findings support the integration of routine audiometric screening into diabetes care.
Primary Source
Diabetes/metabolism research and reviews
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