I have diabetes. Should I get my hearing tested?

If you have diabetes, you likely know that complications can include vision and heart problems. But did you know it can also affect your hearing and sense of balance?

This means that it's a good idea to get a hearing test and regular check-ups, just like you would do for your vision.

In fact, the CDC recommends that people get their hearing tested every year if they have diabetes.

How diabetes affects your hearing and balance

Hearing loss

According to the American Academy of Audiologists, scientists think that high blood glucose levels from untreated diabetes can weaken the ear's blood vessels as well as the nerve cells in the inner ear, known as the "hair cells." More on how we hear.

Like other parts of the body, these hair cells rely on good circulation. Once they are damaged or die, hearing is permanently affected.

Dizziness and risk of falls

Also, diabetes can damage your vestibular system, which is the part of your inner ear that helps with balance. Dizziness and an increased risk of falls can be the result.

Tinnitus (ear ringing)

Though not as studied as the link between diabetes and hearing loss, tinnitus (ringing in the ears) does seem to be more common among people with diabetes. In some cases, this may be from unrecognized hearing loss, because hearing loss frequently causes tinnitus, but people with diabetes are also more likely to have tinnitus even when they don't have hearing loss.

Ear infections/itchiness

While many things can cause itchy ears, certain illnesses, including diabetes and liver disease, can also be culprits. Diabetes makes earwax less acidic, making people with diabetes more prone to outer ear infections (which includes the ear canal). Their ear's skin is also more likely to be damaged.

Good diabetes care is key

The Centesr for Disease Control and Prevention recommends staying on top of your "ABCs" for good diabetes care:

"A1C (a measure of your average blood sugar over 3 months): The goal set for many people is less than 7% for this blood test, but your doctor might set a different goal for you.

Blood pressure: High blood pressure causes heart disease. The goal is less than 140/90 mmHg for most people but check with your doctor to see what your goal should be. If you experience tinnitus from a high blood pressure drug, talk to your doctor.

Cholesterol: LDL or “bad” cholesterol builds up and clogs your blood vessels. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. Ask your doctor what your cholesterol numbers should be.

Smoking: If you smoke or use other tobacco products, take steps to quit. Call 1-800-QUIT-NOW (1-800-784-8669) for support." Smoking is a well-known cause of hearing problems."

Lastly, take a diabetes education class: "Ask your doctor about diabetes education. Medicare pays for 10 hours of this education so you can learn how to control your blood sugar, how to eat right and how to get healthy exercise," says Kathy Dowd, CEO of The Audiology Project.

If you think you have hearing loss, don't delay

The early signs of hearing loss can be tricky to detect, as hearing loss develops slowly. In many cases, people simply feel they "can hear but not understand."

“Because hearing loss is typically gradual, many people don’t realize the extent of their loss until they’ve been seen by an audiologist,” said Bopanna Ballachanda, Ph.D., president of the American Academy of Audiology

If you have a hunch you're not hearing as well as you used to—or a family member or friend has told you this—then don't delay getting help, as you're putting yourself at risk of auditory deprivation and other complications.

As a first step, you can take the validated hearScreenUSA on The Audiology Project's site, or see a provider near you.

Mention your diabetes diagnosis

Be sure to share your diabetes diagnosis as part of your medical history with your hearing care provider. This information, along with the results of your hearing test, will help the two of you determine the best course of treatment going forward.

Usually, the recommended treatment will be hearing aids or cochlear devices.