A COMPARATIVE STUDY OF HEARING STATUS IN TYPE 2 DIABETES MELLITES PATIENTS BASED ON BLOOD SUGAR CONTROL BY USING OTOACOUSTIC EMISSION IN A TERTIARY CARE HOSPITAL IN SALEM, INDIA

Аннотация

Background: Diabetes melletes, a chronic metabolic disease involves development of severe complications affecting nearly every system in the body ^2-4 apart from the basic abnormal blood glucose levels¹. India being the “Diabetic Capital of the world”⁶, has a increasing prevalence rate⁵ , with the age of onset decreasing day by day. Diabetes Mellitus is an important etiological etiological factor for the onset of hearing loss in the elderly  population^7,8. The hearing loss is described as bilateral and progressive sensorineural^11,12. Hearing Loss may be related to microangiopathy, neuronal degenerations or diabetic encephalopathy. The  Study is conducted to  establish effect  of metabolic control on  subclinical auditory dysfunction related with controlled and uncontrolled  Type 2 DM by utilizing otoacoustic emission.

 Methodology: A cross sectional prospective study with 30 patients with metabolically controlled diabetes mellitus and 30 patients with metabolically uncontrolled diabetic mellitus between Jan 2020- to-Aug 2020. The patients were separated into two groups according to the HbA1c levels. Group 1 and Group 2 consisted of controlled Type2 DM cases having HbA1c ≤7% and uncontrolled Type2 DM cases with HbA1c >7%. Otoacoustic Emissions were studied in both the groups and compared.

 Results & Discussion: The present study reports SNHL in 16.66% of Type 2 controlled diabetic patients and 20% of uncontrolled diabetic patients. The majority of them had bilateral mild SNHL. There was a significant difference in the auditory thresholds at all frequencies from 250 Hz to 8000 Hz between Type 2 controlled diabetic patients and uncontrolled diabetic patients, and  a gradual increase in hearing loss from 250 Hz to 8000 Hz. Statistically significant differences were found in the otoacoustic emission measurements of the patients between  metabolically controlled diabetes and uncontrolled groups.

Conclusion: The uncontrolled diabetic patients had increased hearing threshold at all frequencies with gradual increase in hearing loss from 250 Hz to 8000 Hz. In DPOAE (DP-gram and DPOAE I/O) measurements we found significant effect of metabolic control in uncontrolled diabetic patients on hearing loss.

Summary: Diabetes Mellitus is a highly prevalent disease with age of onset decreasing day by day. In this context it is important to emphasize the importance of long term control of blood sugar levels which influences and prevents onset and progression of hearing loss.

 Keywords: Type2 DM, Hearing loss, Otoacoustic emission