The Impact of Diabetes Mellitus on Auditory Perception Skills at the Central Processing Level in Adults: A Systematic Review

OBJECTIVES: This systematic review evaluated the impact of diabetes mellitus on auditory perception skills at the central processing level by comparing individuals with diabetes to controls without this condition. The aim was to identify factors influencing auditory processing abilities and provide clinical implications for monitoring auditory processing function in individuals with diabetes. METHOD: A search of peer-reviewed English-language literature in four academic databases identified 943 relevant articles published before December 2024. Seventeen studies were selected for inclusion in this review, examining auditory perception skills in a total of 1106 individuals with diabetes using a range of subjective tests. Data extracted from these studies included study designs and performance differences between the two groups. Auditory processing skills assessed across the studies included temporal resolution (e.g., identifying gaps-in-noise, detecting amplitude modulation, pattern recognition) and speech understanding in noise (e.g., speech intelligibility at varying noise levels) or binaural processing (e.g., dichotic digits listening). Potential confounding factors such as age, gender, hearing loss, and medical conditions were considered in most studies. RESULTS: Sixteen of the 17 studies indicated that individuals with diabetes had poorer auditory perception skills compared with those without diabetes ( p < 0.05). The effect size for these differences was large (Cohen d > 0.8) in most studies. Age and hearing loss were identified as confounding factors that could affect auditory perception skills. Longer diabetes duration and diabetes-related complications, such as nephropathy, retinopathy, and cardiovascular disease, were also found to be associated with impaired auditory processing abilities in several studies. CONCLUSIONS: Diabetes negatively impacts auditory processing abilities, particularly in temporal resolution and speech understanding in degraded listening environments. Clinical testing using simple, reliable auditory perception measures is recommended for the early detection of auditory processing deficits in individuals with diabetes. In addition, clear guidelines for research in this area are needed to improve demographic matching and ensure study design consistency, enabling more reliable and comparable findings.