Type of publication:
Conference abstract
Author(s):
*Basavaraju N.; *Jones A.; *Wilkes V.; *Moulik P.
Citation:
Diabetes Technology and Therapeutics. Conference: 18th International Conference on Advanced Technologies and Treatments for Diabetes, ATTD 2025. Amsterdam Netherlands. 27(Supplement 2) (pp e265), 2025. Date of Publication: 01 Feb 2025.
Abstract:
Background and Aims: T1D is associated with various comorbidities including sensorineural hearing loss (SNHL). HCL CSII treatment in T1D improves glucose levels rapidly. This may cause short-term worsening of retinopathy and neuropathy (treatment-induced neuropathy in diabetes). We present a case of T1D on HCL CSII with worsening hearing loss. Method(s): A 46-year-old gentleman with T1D for 30 years with pre- proliferative retinopathy had mild right sided tinnitus and sensorineural hearing loss (on pure tone audiometry) diagnosed 8 years ago. MRI internal auditory meatus was normal. He was commenced on HCL CSII (Omnipod 5 with Dexcom G6). Result(s): Pre-HCL HbA1c was 75mmol/mol. Glucose management indicator (GMI) after 4weeks rapidly dropped to 53mmol/mol which further reduced to 48mmol/mol in 6months. He reported worsening of right sided tinnitus and hearing loss with development of new left sided tinnitus. He also developed maculopathy. Conclusion(s): Approximately 9.2/1000 people with T1D develop debilitating SNHL every year. In people aged 40-60- years with T1D, hearing threshold in high frequencies(4,000- 8,000Hz) was significantly higher (25-30dB) when compared to age-matched controls (5-10dB). The mechanisms are damage to outer and inner hair cells, loss of spiral ganglion neurons through apoptosis, thickening of basement membrane, and pathologies involving stria vascularis and spiral ligament of the cochlear lateral wall. Whilst causality cannot be inferred from this case, the temporal sequence of rapidly improved glycaemic control with worsening tinnitus and hearing loss raises a possibility of its association. This requires further study preferably with pure tone audiometry, in a randomised clinical trial setting.
DOI: 10.1089/dia.2024.78502.abstracts
