Background Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disorder associated with widespread microvascular and metabolic complications affecting multiple systems. The auditory system may be vulnerable through similar pathophysiological mechanisms. Diabetes-related hearing loss represents an emerging, overlooked complication that may affect children early in the disease course as a subclinical, subtle yet significant complication of T1DM, even in the absence of overt hearing loss. This study aimed to evaluate cochlear and neural auditory function, detect subclinical hearing deficits in children with T1DM with at least 5 years of disease duration, and correlate these findings with clinical and metabolic variables. Patients and methods A case-control study including 35 children with T1DM (70 ears) and 20 healthy controls (40 ears), aged 8–17 years. The comprehensive evaluation included detailed history taking, a thorough clinical assessment, and audiological assessments otoscopy, tympanometry, transient evoked otoacoustic emissions (TEOAEs), and auditory brainstem response. Metabolic parameters, including glycated hemoglobin (HbA1c), lipid profile, blood pressure, and screening for microvascular complications, were recorded and correlated with auditory findings. Results The mean age of the patients was 12.29±2.63 years, with a disease duration of 7.78±2.47 years. Poor glycemic control was prevalent (97.1% with HbA1c>7%, mean 10.84±2.30%). Children with T1DM demonstrated significantly reduced TEOAE signal-to-noise ratios across all frequencies (1000–4000 Hz, P <0.05), with an overall response of 20.00±3.76 dB sound pressure level compared with 23.13±4.03 dB sound pressure level in the controls ( P <0.001). Auditory brainstem response revealed prolonged absolute latencies for waves I, III, and V ( P =0.003 for all), with preserved interpeak latencies. TEOAE responses showed no significant metabolic correlations, while wave V latency correlated significantly with diastolic blood pressure ( r =0.264, P =0.027), HbA1c ( r =0.246, P =0.040), total cholesterol ( r =0.305, P =0.010), and albumin-to-creatinine ratio ( r =0.321, P =0.007). These findings indicate early cochlear and neural pathway impairments preceding detectable hearing loss. Conclusions Subclinical auditory dysfunction, affecting both cochlear and neural pathways, is present in children with T1DM despite normal clinical hearing, reflecting early microvascular and metabolic injury. These findings support the inclusion of routine audiological screening in comprehensive pediatric diabetes care as a non-invasive screening tool for early detection and intervention. This may preserve hearing and improve long-term neurological outcomes.
El‐Sohaimy et al. (2025) studied this question.