diabetes and hearing loss
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Diabetes and Hearing Loss. Purpose of Presentation. To make diabetes educators aware of the link of diabetes to hearing loss and the need for intervention: Hearing loss and chronic disease/ototoxic meds Why does hearing loss occurs with diabetes - PowerPoint PPT PresentationTRANSCRIPT
Diabetes and Hearing Loss
Purpose of Presentation
To make diabetes educators aware of the link of diabetes to hearing loss and the need for intervention: Hearing loss and chronic disease/ototoxic meds Why does hearing loss occurs with diabetes What is the impact of hearing loss on quality of life
issues What are the recommendations for Patients with
Diabetes, in light of hearing loss
Chronic Disease with Secondary Hearing Loss
A. DiabetesB. Thyroid disease (hypothyroidism)C. Multiple sclerosisD. Chronic Renal DiseaseE. Cardiovascular DiseaseF. Alport’s SyndromeG. Paget’s DiseaseH. Cogan’s SyndromeI. Dementia
Chronic Kidney Disease & Hearing Loss
Association of CKD & Hearing Loss Known for Decades
Kidney & Stria Vascularis of Cochlea Share Physiologic, Ultrastructual and Antigenic Similarities
Diabetes Often Results in Chronic Renal Disease
Therefore, the Link Between Diabetes and Hearing Loss May Be Indirect but Exists
Vasculature of the EarBlood Vessels of the
Inner EarArteries of the Middle
Ear
Comorbidity of Diabetes and other Health Issues
Heart Problems
Balance Issues
Vision Impairment
Hearing Loss
Neuropathy/Pain Management
PAIN MANAGEMENTINFECTION CONTROL
HORMONE REPLACEMENTFLUID RETENTION
CANCER CHEMOTHERAPY
WHO IS CHECKING YOUR PATIENT’S HEARING WHEN THEY USE THESE
MEDICINES?
Medicines and Your Diabetes Patients
Ototoxic Drugs
A. Aminoglycoside Antibiotics (mycin drugs)B. Loop Inhibiting Diuretics (lasix,
furosemide)C. Salicylates (aspirin, darvon, darvocet)D. Cancer ChemotherapyHormone Replacement treatmentE. Quinine
Diabetes and Hearing Loss
In people age 60 and older with type 2 diabetes:
High blood sugar causes tiny blood vessels in the inner ear to break, disrupting sound reception.
Associated balance problems may come from neuropathy Mechanisms related to neuropathic or microvascular factors,
inflammation, or hyperglycemia may be mediating the association of diabetes and hearing impairment (Bainbridge et al, 2010)
Significant hearing differences were at all frequencies for NIDDM subjects, but for IDDM subjects, differences were at 1,000 Hz and below, and 10,000 Hz and above (Austin et al, 2009)
FIRST STEP: SCREENING IN YOUR OFFICE
SECOND STEP: REFER TO AN AUDIOLOGIST
THIRD STEP: TREATMENT AND FOLLOW UP
FOURTH STEP: GETTING USED TO A NEW WAY OF HEARING
Detection, Identification, Diagnosis and Treatment
of Hearing Loss
Effects of Untreated Hearing Loss
embarrassment, fatigue, irritabilitytension/stressavoidance of social activities withdrawal from personal relationships depression, negativismdanger to personal safety social rejection by othersimpaired memory and ability to learn new tasksPoor job performance and reduced earning powerDiminished psychological and overall health(Better Hearing Institute, 2009)
Auditory Deprivation
Although we hear with our ears, it is the brain that is the true hearing organ
Over time, the brain’s ability to understand speech is often affected by hearing loss
Once the ability to understand is lost, that ability can be difficult, if not impossible, to regain
Wearing hearing instruments can assist the brain in keeping the ability to understand from being lost
Recommendations for Monitoring Hearing
Get a hearing test when first identified with diabetes
Ongoing assessment of hearing levels at least once a year
Encourage use of hearing aids if recommended
Seek an audiologist for comprehensive hearing services and monitoring
Improved Hearing Means:
Better family relationships and communication Less isolation and less prone to depression
Better job performance
More energy/less stress
Better quality of life: involvement in church, family and group activities
Your Audiologist will:
Knows Your History & Meds
Watch For Otologic Complications
Refer to Primary or Specialty Care
Reinforce the Team Goals with Diabetes Educators
Swift Intervention for Malignant Otitis
NC Diabetes State Plan
Clinical Interventions “Improve screening for and management of diabetes
by encouraging healthcare providers to follow ADA guidelines, and include oral health and auditory screening as part of baseline assessments for people with diabetes.”
Counseling and Education “Raise awareness about diabetes uncommon co-
morbidities including hearing loss and sleep apnea.”
Resources: Hearing Screening
Questionnaires Patient Spouse
Test Equipment Automated
Whisper test/Word test
Resources: Audiologists in NC
http://www. ncboeslpa.org http://webportal.audiology.org/Custom/
FindAnAudiologist.aspx http://www.audiologist.org/audiologist-
directory-search