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Knowledge, Attitudes, and Practices (KAP) Regarding Diabetes-Related Hearing Loss Among Providers and Patients: A
Mehwish Nisar1, Muhammad Waqas Nisar Ahmed2, Anjana Rajagopal1
1School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia.
Background:
Hearing loss remains significantly underrecognised as a diabetes complication, despite diabetic individuals experiencing double the risk of sensorineural hearing impairment. This review synthesised healthcare provider and patient knowledge, attitudes, and practices (KAP) concerning diabetes-related hearing loss.
Methods:
Using Arksey and O'Malley's framework and PRISMA-ScR guidelines, systematic searches were conducted across five databases (PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library) through August 2025. Grey literature and reference screening supplemented database searches. Eligible studies examined KAP among healthcare professionals and diabetic patients.
Results:
Five studies from four countries reported KAP findings were identified from 2029 records, encompassing 2813 healthcare providers. Only one study included KAP data from patients. Knowledge deficits were pronounced: American provider awareness ranged 25.6-44.5%, contrasting sharply with >94% awareness of other complications. Only 24.3% of Chinese providers demonstrated complete understanding, while 59.7% of South African practitioners remained unaware of auditory complications. Patient knowledge was similarly limited (21% recognition). Attitudes showed moderate engagement, with 68-75% of Chinese practitioners accepting management responsibilities. Barriers included unfamiliar guidelines, competing priorities, and restricted audiological access. Practices were suboptimal: 16.9% conducted routine screening, referrals remained reactive, and 64.9% never discussed hearing risks. Training opportunities were minimal.
Conclusions:
Substantial KAP deficits exist regarding diabetes-related hearing loss. Recognition disparities compared to established complications represent lost opportunities for early intervention. Urgent needs include standardised assessment instruments, large-scale intervention studies, and comprehensive educational programs to integrate hearing health into standard diabetes management protocols.
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Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...