Risk of developing sudden sensorineural hearing loss in diabetic patients: A population-based cohort study

OBJECTIVES: To explore the risk of development of sudden sensorineural hearing loss (SSHL) among diabetes mellitus patients. STUDY DESIGN: A retrospective cohort study. SETTING: Population-based study of Taiwan National Health Insurance Research Database. PATIENTS: Approximately 26,556 newly diagnosed diabetic patients and 26,556 comparison subjects without diabetes mellitus were selected from claims made during 2000 to 2004. MAIN OUTCOME MEASURES: The incidence of sudden sensorineural hearing loss (SSHL) at the end of 2009 was determined. RESULTS: The incidence of SSHL was 1.54-fold higher in the diabetic group compared with the nondiabetic group (1.29 versus 0.78 per 1,000 person-years), and using Cox proportional hazard regressions, the adjusted hazard ratio (HR) was 1.592 (95% confidence interval [CI], 1.295-1.957). The risk of developing SSHL increased substantially to an HR of 2.060 (95% CI, 1.051-4.037), for patients who required triple antidiabetic medication compared with diabetic patients treated with a single antidiabetic drug. An increased risk of developing SSHL, with adjusted HRs of 1.574 (95% CI, 1.091-2.271) and 2.842 (95% CI, 1.880-4.295), was observed in diabetic patients with newly diagnosed comorbidities of retinopathy or retinopathy combined with renal insufficiency, which are both expected to reflect the severity of diabetes. CONCLUSION: Diabetes mellitus was significantly associated with an increased risk of developing SSHL. Coronary heart disease or retinopathy comorbidities in diabetic patients seemed to be associated with an increased risk of developing SSHL. The risk of developing SSHL increased with the severity of diabetes.