Diabetes and Auditory-Vestibular Pathology

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The relationship between diabetes mellitus (DM) and the auditory/vestibular system has been investigated for more than a century. Most population-based investigations of hearing loss in persons with diabetes (PWD) have revealed a slow progressive, bilateral, high-frequency sensorineural hearing loss. Despite the growing research literature on the pathophysiology of DM-related hearing loss using various animal models and other human studies, knowledge of specific mechanism of the degenerative changes of the inner ear and/or auditory nerve is far from full elucidation. Recent investigations of the mechanisms underlying the association between hearing loss and DM suggest complex combined contributions of hyperglycemia, oxidative stress resulting in cochlear microangiopathy, and auditory neuropathy. An even lesser understood complication of DM is the effect on the vestibular system. Here we provide an overview of animal and human evidence of pathophysiological changes created by DM and its effects on auditory-vestibular anatomy and function.