Diabetes mellitus and the incidence of hearing loss: A cohort study

Min Beom Kim, Yiyi Zhang, Yoosoo Chang, Seungho Ryu, Yuni Choi, Min Jung Kwon, Il Joon Moon, Jennifer A. Deal, Frank R. Lin, Eliseo Guallar, Eun Chul Chung, Sung Hwa Hong, Jae Ho Ban, Hocheol Shin, Juhee Cho

Research output: Contribution to journalArticlepeer-review


Background: To evaluate the association between diabetes mellitus (DM) and the development of incident hearing loss. Methods: Prospective cohort study was performed in 253 301 adults with normal hearing tests who participated in a regular health-screening exam between 2002 and 2014. The main exposure was the presence of DM at baseline, defined as a fasting serum glucose 126 mg/dL, a self-reported history of DM or current use of anti-diabetic medications. Pre-diabetes was defined as a fasting glucose 100–125 mg/dL and no history of DM or anti-diabetic medication use. Incident hearing loss was defined as a pure-tone average of thresholds at 0.5, 1.0 and 2.0 kHz > 25 dB in both right and left ears. Results: During 1 285 704 person-years of follow-up (median follow-up of four years), 2817 participants developed incident hearing loss. The rate of hearing loss in participants with normal glucose levels, pre-diabetes and DM were 1.8, 3.1 and 9.2 per 1000 person-years, respectively (P < 0.001). The multivariable-adjusted hazard ratios for incident hearing loss for participants with pre-diabetes and DM compared with those with normal glucose levels were 1.04 (95% confidence interval 0.95–1.14) and 1.36 (1.19–1.56), respectively. In spline regression analyses, the risk of incident hearing loss increased progressively with HbA1c levels above 5%. Conclusions: In this large cohort study of young and middle-aged men and women, DM was associated with the development of bilateral hearing loss. DM patients have a moderately increased risk of future hearing loss.

Original languageEnglish (US)
Pages (from-to)717-726
Number of pages10
JournalInternational journal of epidemiology
Issue number2
StatePublished - Apr 1 2017


  • Cohort study
  • Diabetes mellitus
  • Hearing loss
  • Incidence
  • Risk factors

ASJC Scopus subject areas

  • Epidemiology

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