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The Importance of Extended High Frequencies in Hearing Evaluation of Pediatric Patients with Type 1 Diabetes
Selis Gülseven Güven1, Çiğdem Binay2
1Çorlu State Hospital, Tekirdağ; Trakya University Faculty of Medicine, Department of Otorhinolaryngology, Clinic of Head and Neck Surgery, Edirne, Turkey
Insights
Children with type 1 diabetes (T1D) may have early signs of hearing loss, even without symptoms. Extended high-frequency (EHF) audiometry can detect subclinical hearing issues in diabetic children, prompting closer glucose monitoring.
Area of Science:
- Pediatrics
- Otolaryngology
- Endocrinology
Background:
- Type 1 diabetes (T1D) is a common childhood disease with potential systemic effects.
- Diabetes can lead to progressive sensorineural hearing loss, typically affecting high frequencies.
- Subclinical hearing loss in children with T1D may serve as an early indicator.
Purpose of the Study:
- To investigate extended high-frequency (EHF) hearing sensitivity in children with T1D.
- To identify EHF audiometry as an early marker for hearing loss in the conventional range.
- To assess the relationship between T1D and early-onset hearing impairment.
Main Methods:
- A case-control study involving 42 children (21 with T1D, 21 controls).
- Conventional and EHF (14,000–18,000 Hz) audiometry were performed.
- Blood biochemistry and HbA1c levels were measured in the diabetes group; data analyzed using statistical tests and logistic regression.
Main Results:
- Children with T1D had significantly higher mean hearing thresholds than controls at conventional frequencies (500–8,000 Hz).
- A higher number of ears in the T1D group showed elevated thresholds at EHF (14,000–18,000 Hz) compared to controls.
- Hearing thresholds were normal in the conventional range but elevated in the EHF range for children with T1D.
Conclusions:
- Children with T1D exhibit elevated hearing thresholds in the EHF range despite normal conventional hearing.
- EHF audiometry is a potentially effective tool for detecting subclinical hearing loss in diabetic children.
- Close blood glucose monitoring is recommended for diabetic children with elevated EHF hearing thresholds to prevent conventional hearing loss.
Objective:
Type 1 diabetes (T1D), one of the most common childhood diseases worldwide, can cause hearing loss through systemic effects. Diabetes-induced hearing loss is considered a progressive sensorineural hearing loss with a gradual onset, typically occurring at high frequencies (HFs). Extended HF (EHF) hearing sensitivity in children with T1D who did not complain of hearing loss was investigated as an early marker for hearing loss at the standard/conventional frequency range of hearing.
Methods:
Forty-two children (21 with T1D and 21 healthy controls) were evaluated in a case-control design. Conventional and EHF (14,000, 16,000, and 18,000 Hz) audiometry were performed. The diabetes group underwent routine blood biochemistry and glycated hemoglobin A1c measurements. The data were analyzed by the Student’s t-test, Mann-Whitney U test, chi-square test, and logistic regression analysis.
Results:
The mean hearing thresholds were significantly higher (p<0.05) in the diabetes group than in controls at 500, 2,000, 4,000, and 8,000 Hz [all <15 decibel hearing level (dB HL)]. The number of ears with thresholds >15 dB HL at 14,000-18,000 Hz but ≤15 dB HL at 500-4,000 Hz was significantly higher in the diabetes group than in the control group (p=0.049).
Conclusion:
Children with diabetes showed normal hearing thresholds within the conventional audiometric frequency range but they had higher hearing thresholds during EHF audiometry when compared with controls. Audiometry in these children should be performed using frequencies above 8,000 Hz combined with the conventional frequency range. EHF audiometry may be an effective method for identifying subclinical hearing loss in children with diabetes. Thus, diabetic children with an EHF mean hearing threshold above 15 dB HL should be monitored more closely in terms of blood glucose regulation to prevent diabetes-related hearing loss at the conventional frequency range.
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