By Lolly Wigall, AuD
Several months ago, my sister and I were talking about our health. We were discussing our own health issues as well as those in the rest of our family. We were remembering a time when no one in the family shared any health concerns with anyone else in the family. It was all very private and “no one’s business.”
As children neither of us could remember a discussion about our grandparents’ health. If anything, the issue was stated once, and then never discussed again. Several examples came to mind.
We both remembered our maternal grandfather with multiple sclerosis. We recalled that first he used a cane and then was confined to a wheelchair. But, neither of us remembers any discussion of the progression of the disease or the implications. Health matters were not a topic of conversation.
Diabetes became a reality in my life in 2004 when my husband’s blood sugar measured 400! He was told to go directly to the hospital. Instead he came home, gathered his overnight paraphernalia, and asked a friend to drive him to the hospital.
Diabetes was a far different disease from what I remembered my great aunt’s having. I had no idea then what the disease was or the implications.
After my husband’s stint in the hospital, we were sent to a nutritionist to teach him/us how to eat to control his blood sugar. We changed our eating habits. We tried to get a little more exercise. My husband studied all he could about the disease. He can tell you about everything regarding food and diabetes. I don’t remember a lot of it, but that’s okay because he does the meal planning, shopping, and cooking in our home. I use that as an excuse to forget some things.
His diabetes diagnosis meant seeing a new physician: an endocrinologist. My husband was told to check his blood sugar three times a day. He was supposed to see an eye doctor annually to monitor his vision. And, he was to see a podiatrist to monitor his toes and toenails. He was also instructed to get more exercise and lose weight.
We learned that diabetes can affect blood circulation. Poor circulation can cause some people to develop neuropathy in their feet and hands. That’s why diabetes patients are told to have their extremities checked periodically.
What About Hearing Loss…?
As an audiologist I began to wonder about the tiny hair cells in the inner ear. Could they be affected by poor blood circulation? Could this be the reason my husband is not hearing me as well as he used to? Could he be getting hearing loss from diabetes? How come the doctors didn’t tell us about this?
Sure enough, there have been studies done that suggest that diabetes can affect a person’s hearing. Physiologically, the high-frequency hair cells are usually affected first by hearing loss.
In the inner ear they (hair cells) are the first receptors of the signal. Over time, they “wear out” and disappear. When there are limited or reduced hair cells, hearing loss is the result.
When I read the articles about diabetes and hearing loss, I began to wonder why endocrinologists do not routinely insist on annual hearing tests for all their patients. I also wondered why primary care physicians who follow diabetic patients don’t suggest an annual hearing test.
Visiting Specialists
The time came for the next visit to the endocrinologist. My husband brought his meter so they could read his bloods sugar levels. The nurse read the meter to document his readings. The doctor checked his legs and toes and asked when his last eye exam had been. But there was no mention of an annual hearing test. Being a concerned wife, I began testing my husband’s hearing every year.
I try to keep up with the literature and research findings in audiology. Periodically I check the American Diabetes Association website to monitor links between hearing loss and diabetes. Over the years, such articles have come and gone from the site. They usually talk about a correlation of diabetes with hearing loss, but they do not go as far as to suggest an annual hearing test.
My brother was diagnosed with diabetes. Then a few years ago, one of my younger sisters was as well. I suggested to both of them that an annual hearing test would be a good idea. My brother politely listened to me, but I don’t think he has had a hearing test. My sister, on the other hand, has repeatedly asked her doctor for a referral for a hearing test, but her physician has repeatedly refused to make the referral.
It seems like a good medical practice to have a baseline test of every body part. And, without a referral, my sister would have to pay out of pocket for the hearing test.
I don’t want to say anything bad about her physician. I don’t know him or her. But, I cannot understand the rationale in not having a baseline hearing evaluation. Unfortunately, she and I live 3000 miles apart, so I can’t give her a hearing test. I will try to remember to do so the next time she visits us.
November is Diabetes Awareness Month in the United States. We are seeing posters, articles, television announcements, and other programs as part of nationwide campaign to raise the public’s awareness of the disease. Eating healthily and measuring blood sugar are two key factors in monitoring the disease on a daily basis. It is also definitely important to have annual eye and foot examinations. In addition, as an audiologist, I encourage anyone with diabetes to get a baseline hearing test.