Abstract
Although auditory alterations are not a typical symptom of diabetes mellitus (DM), they can occur in patients with type 1 DM. The findings of previous studies are controversial, because the frequency and degree of hearing loss varies, and quite often alterations are still subclinical. The typical test used to detect and manage hearing loss is the audiogram, but this test alone is only capable of detecting alterations due to injury of the inner hair cells and/or alterations in the central auditory pathway. However, auditory alterations resulting from a dysfunction that is still subclinical are only able to be detected through electrophysiological auditory tests, such as the otoacoustic emissions (OAE) and the auditory brainstem response (ABR) tests. Thus, the purpose of this paper is to review the studies that utilize the OAE and ABR tests, and to verify if the dysfunction is cochlear and/or neural in patients with type 1 DM. The findings of this review demonstrate that patients with type 1 DM can have auditory alterations stemming from a central cochlear origin. Following this finding, early diagnosis is very important in order to implement preventative treatments and initiate therapy.
Highlights
The American Diabetes Association (2010) [1] defines diabetes mellitus (DM) as a group of metabolic diseases characterized by hyperglycemia, which is a result of alterations in the secretion and/or action of insulin
In most of the cases, the auditory alterations occurring from type 1 DM are not detected in conventional auditory tests, such as the audiogram, because it does not possess the necessary sensitivity and specificity to detect all types of alterations occurring from this pathology
Considering that the audiogram does not detect the observed early alterations in patients with DM, the type OAE (TOAE) would be a sensible test for early detection, while the DPOAE test would be more specific to the frequencies affected in accordance with the advance of age
Summary
The American Diabetes Association (2010) [1] defines diabetes mellitus (DM) as a group of metabolic diseases characterized by hyperglycemia, which is a result of alterations in the secretion and/or action of insulin. Auditory alterations are not a typical symptom, they can occur in patients with type 1 DM These alterations are normally related to structures of the inner ear (cochlea), including Corti’s organ and structures of the central auditory pathway, from the nerve until the auditory cortex. This mechanical-electrical transduction is the transmission of sound that initially occurs within a mechanical system, until contacting the inner hairs cells, when it is changed into electric potential that will lead the auditory information through the central nervous system Alterations in these inner structures are called sensorineural, and the examination best known for identifying possible hearing loss is the audiogram [4]. The audiogram is only capable of detecting alterations occurring from injury to the inner hair cells and/or alterations in the central auditory pathway. In most of the cases, the auditory alterations occurring from type 1 DM are not detected in conventional auditory tests, such as the audiogram, because it does not possess the necessary sensitivity and specificity to detect all types of alterations occurring from this pathology
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