Type 2 Diabetes and Hearing Loss: The Silent Connection between Hearing Loss, Balance and Brain Health
Have you noticed the TV creeping louder or conversations feeling harder to follow, but blamed it on tiredness or age? For many people, that quiet change in hearing is linked to type 2 diabetes and hearing loss.
Hearing loss can affect people with type 1 diabetes, type 2 diabetes, and even prediabetes. Type 2 diabetes is the most common form of diabetes in South African adults, including many people we see across KwaZulu‑Natal in areas such as Durban and Ballito. The guidance in this article is relevant for anyone living with diabetes, no matter where you are in the world.
The tricky part is that hearing changes are often slow and silent, so they are easy to miss until they start to affect everyday life.
How Are Type 2 Diabetes and Hearing Loss Linked?
High blood sugar does not only affect your eyes, kidneys, or feet. It also affects the tiny blood vessels and nerves inside your inner ear. These delicate structures help carry sound from your ear to your brain.
When blood sugar stays high for long periods, it can damage these tiny vessels, just like it does elsewhere in the body. Over time, this damage can reduce how well the inner ear works, so sounds start to feel softer or less clear.
Research shows that hearing loss is about twice as common in adults with diabetes compared with those without it. People with prediabetes already have a higher risk too. Poor blood sugar control, smoking, and high blood pressure can all increase the chance of hearing problems, especially in type 2 diabetes.
What Research Says About Type 2 Diabetes, Hearing Loss, and Brain Health
Trusted health bodies are speaking more about the link between diabetes and hearing loss. The CDC reports that adults with diabetes are much more likely to have hearing loss than those without diabetes.
Local organisations, such as Diabetes South Africa, also highlight hearing loss as a real complication in type 2 diabetes. International charities, including the Hearing Health Foundation, call it a “silent side effect” because it often creeps in slowly.
Most research focuses on adults with type 2 diabetes, but studies show higher risks in people with type 1 diabetes and prediabetes, too.
Diabetes is not simply a “sugar problem”. It is a long-term condition that affects blood vessels, nerves, and inflammation in the body. These same systems are vital for clear thinking, memory, and healthy brain ageing. That is why diabetes is now seen as one of the strongest modifiable risk factors for dementia, alongside treating hearing loss.
Diabetes and Dementia: How They Connect
Researchers have found links between diabetes and several types of dementia.
1. Alzheimer’s Disease
Diabetes can increase the risk of Alzheimer’s disease by about 50 to 60 percent, because:
Insulin resistance affects brain cells that support memory
Poor glucose control may increase harmful proteins in the brain
Ongoing inflammation can damage brain structure over time
Some experts refer to this pattern as “type 3 diabetes” because the brain’s response to insulin is so involved.
2. Vascular Dementia
Vascular dementia is closely connected to blood vessel health. Diabetes can cause:
Small vessel damage in the brain
Tiny strokes or “lacunar” infarcts
Changes in the brain’s white matter
Lower blood flow to key brain areas
These problems can lead to slower thinking, poor concentration, and difficulty planning or organising.
3. Mixed Dementia
Many older adults have a mix of both Alzheimer’s changes and blood vessel damage. Diabetes can speed up both pathways. This mixed dementia is now thought to be very common in people with long-standing metabolic conditions.
Why Hearing and Brain Health Are Linked in Diabetes
The hearing and memory systems share two key weaknesses in diabetes.
High energy demand
The tiny hair cells in your inner ear and the memory centres in your brain both need a lot of oxygen and energy. When glucose control is poor, these systems can struggle. The result can be both unclear hearing and changes in memory or thinking.
Extra “listening effort” from subtle hearing loss
If your hearing is slightly reduced, your brain has to work much harder to decode speech.
More mental energy goes into “just hearing the words”, so there is less capacity left for understanding or remembering them. Over time, this extra load on the brain is linked with a higher risk of cognitive decline and dementia.
This is why early hearing checks in diabetes are seen as protective, not only for hearing but also for long-term brain health.
“If you are living with diabetes and notice changes in your hearing, balance, or mental clarity, consider booking a comprehensive hearing and balance assessment at our Durban or Ballito branches. Early support makes a powerful difference.”
Early Warning Signs of Hearing Loss in People With Diabetes
Catching hearing changes early makes day-to-day life much easier. Think of it like checking your eyes or your feet.
Common Symptoms You Should Not Ignore
Turning up the TV or radio more than before
Feeling that people are mumbling, especially children or soft voices
Asking others to repeat themselves often
Struggling to follow group conversations or chatter in noisy places
Ringing, buzzing, or whistling sounds in your ears
These symptoms can appear slowly in anyone with type 1, type 2, or prediabetes.
When to Talk to an Audiologist or Doctor
If these signs last for more than a few months or start to affect your work, social life, or family time, it is time to speak up. Mention any hearing changes at your next diabetes check, or book a hearing test with a local audiologist.
People with type 2 diabetes, especially, should see hearing checks as part of their regular care, just like blood tests or eye checks. Many clinics now let you book a comprehensive audiological assessment online, which may include:
Pure tone audiometry (PTA)
Speech reception threshold (SRT) testing
Speech in noise testing (to see how you cope in real-life situations)
A brief cognitive screener to track memory and thinking changes that may appear even before the audiogram shows clear hearing loss
These detailed checks help pick up early changes in both hearing and cognition, long before they cause major problems in daily life.
To learn more about how Hoffman Audiology conducts comprehensive hearing tests and why our approach matters, read our full blog here.
If you live in Durban or Ballito, you can book an assessment online with Hoffman Audiology and fit it into your normal diabetes care routine.
Protecting Your Hearing When You Have Type 2 Diabetes
You cannot always reverse existing hearing loss, but you can slow things down and protect the hearing you still have. Small, steady habits make a real difference.
Control Blood Sugar to Protect Tiny Ear Blood Vessels
Keeping blood sugar as stable as you can helps protect those tiny ear vessels and nerves. This applies to people with type 1, type 2, and prediabetes.
For many adults with type 2 diabetes, there are other players in the mix, such as high blood pressure or high cholesterol. Managing these with your diabetes team supports your heart, brain, and ears at the same time.
Healthy Hearing Habits You Can Start Today
Simple steps can support your ears:
Avoid very loud noise where possible
Use earplugs or earmuffs at concerts, clubs, or when using power tools
Do not smoke, and get help to quit if you do
Keep regular medical and diabetes check-ups
Book a professional hearing test if you notice any change
Diabetes, Balance, and Fall Risk: More Than Just Hearing Loss
Diabetes does not only affect blood sugar. It also affects the small nerves and blood vessels that help you see clearly, feel the ground under your feet, hear well, and stay upright. When any of these systems change, your body has to work harder to stay steady. When two or three are affected at once, the risk of falling rises a lot.
How Diabetes Affects Your Vision
Your eyes rely on tiny blood vessels. Diabetes can damage these vessels and lead to:
Blurry vision
Difficulty seeing in low light
Reduced contrast sensitivity
Slower visual processing
Your eyes play a huge role in balance. If your vision is less sharp, it is easier to misjudge steps, slopes, curbs, or moving objects.
Vision changes mean it is harder to move safely, which raises fall risk.
How Diabetes Affects Your Inner Ear Balance System
Inside your inner ear is your vestibular system. It works like your body’s internal balance gyroscope. It helps you:
Keep your head steady
Walk in a straight line
Stay balanced when you turn
Coordinate eye and body movements
Diabetes can affect this system because:
It needs healthy blood flow
It depends on high-energy cells that struggle when glucose is not well controlled
It uses nerve cells that can be damaged in diabetic neuropathy
If your vestibular system is affected, you may notice:
Unsteadiness, especially in the dark
Feeling “off balance” when moving quickly
Difficulty walking on uneven ground
A need to hold onto railings
More dizziness when turning
Vestibular problems mean weaker balance signals from the inner ear, which raises fall risk.
If you would like to understand more about dizziness or unsteadiness, visit our Balance Assessment page.
How Diabetes Affects Your Nerves (Peripheral Neuropathy)
Over time, high blood sugar can damage the small nerves in your hands and feet. This peripheral neuropathy can cause:
Numbness
Tingling or burning
A “cotton wool” feeling under the feet
Less awareness of where your feet are when you walk
If your feet cannot “feel” the ground properly, your brain gets less feedback about your balance. This makes it easier to misstep or lose stability, especially:
On uneven surfaces
In low light
When walking quickly
Neuropathy means less feedback from the feet, which again raises fall risk.
Why Monitoring Your Hearing, Balance, and Vision Matters
Your feet, eyes, ears, and inner ear balance system all work together to keep you steady.
If one system is affected, your balance is more fragile
If two or three are affected, which is common in diabetes, the chance of falling rises significantly
Falls can lead to:
Broken bones
Loss of independence
Hospital stays
Fear of moving, which then weakens your muscles further
The goal is not to frighten you. It is to give you clear information so you can act early.
Diabetes affects the smallest blood vessels and the most energy-hungry cells in the body, including your inner ear hair cells and your brain’s memory centres. When glucose is not well controlled, it slowly reduces the efficiency of the systems that support clear hearing, sharp thinking, and stable balance. Monitoring hearing, vision, nerves, and cognition becomes part of full diabetes care, just like checking your kidneys or feet.
The Good News: Many Problems Are Preventable
By checking these systems regularly, your team can pick up small changes before they turn into big problems. Helpful assessments include:
Hearing and balance testing, especially if you feel unsteady
Speech in noise testing and cognitive screening with your audiologist
Foot and neuropathy checks
Regular eye exams
Ongoing blood sugar management
Strength and stability exercises with a physio or trainer
When we catch changes early, we can protect your safety, mobility, and independence.
Simple take-home message:
Diabetes can quietly affect the nerves in your feet, your vision, your inner ear balance system, your hearing, and your memory. These changes add up and can increase your risk of falling and feeling disconnected. By checking these systems regularly, we keep you steady, confident, and safe, and we can act before small changes become big problems.
Conclusion: Make Hearing and Balance Part of Your Diabetes Care
Type 2 diabetes and hearing loss are closely linked, but hearing changes can also affect people with type 1 diabetes and prediabetes. The same tiny systems that support hearing also support memory, balance, and clear thinking.
The earlier you notice the signs, the easier it is to stay connected to the people and sounds you love, and to stay on your feet and independent.
Treat hearing, balance, and brain health as part of your diabetes care, not an extra. Talk to your doctor or audiologist, and consider booking a hearing and balance test if anything feels different.
You can book an appointment with Hoffman Audiology online at our Durban or Ballito Practice and make these checks part of your regular diabetes plan.
Your future self, and your future conversations, will thank you.