Li SF, Yu SY, Liu YY, Fu SC, Xiong YP. Metabolic basis of sudden sensorineural hearing loss in diabetes mellitus: From epidemiological association to mechanistic understanding. World J Diabetes 2026; 17(3): 115180 [DOI: 10.4239/wjd.v17.i3.115180]
Corresponding Author of This Article
Yuan-Ping Xiong, MD, PhD Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, No. 17 Yongwaizheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. xiongyp@ncu.edu.cn
Research Domain of This Article
Otorhinolaryngology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 15, 2026 (publication date) through Mar 15, 2026
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Journal Information of This Article
Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li SF, Yu SY, Liu YY, Fu SC, Xiong YP. Metabolic basis of sudden sensorineural hearing loss in diabetes mellitus: From epidemiological association to mechanistic understanding. World J Diabetes 2026; 17(3): 115180 [DOI: 10.4239/wjd.v17.i3.115180]
Shu-Fen Li, Shu-Yue Yu, Yi-Yuan Liu, Yuan-Ping Xiong, Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang 330006, Jiangxi Province, China
Shu-Cai Fu, Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Jiujiang University, Jiujiang 330025, Jiangxi Province, China
Co-first authors: Shu-Fen Li and Shu-Yue Yu.
Co-corresponding authors: Shu-Cai Fu and Yuan-Ping Xiong.
Author contributions: Li SF and Yu SY contributed to data collection, and they contributed equally to this manuscript as co-first authors; Li SF, Yu SY, Liu YY, and Xiong YP contributed to the manuscript creation; Li SF, Yu SY, and Xiong YP contributed to manuscript revision; Li SF, Fu SC, and Xiong YP contributed to the study design; Liu YY and Fu SC contributed to data interpretation; Fu SC and Xiong YP contributed to study concept, and they contributed equally to this manuscript as co-corresponding authors; All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Supported by the National Natural Science Foundation of China, No. 82471183 and No. 82260224; and Jiangxi Natural Science Foundation Project, No. 20242BAB25491.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Corresponding author: Yuan-Ping Xiong, MD, PhD Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Jiangxi Medical College, No. 17 Yongwaizheng Street, Donghu District, Nanchang 330006, Jiangxi Province, China. xiongyp@ncu.edu.cn
Received: October 10, 2025 Revised: November 22, 2025 Accepted: January 7, 2026 Published online: March 15, 2026 Processing time: 153 Days and 4.9 Hours
Abstract
Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that necessitates prompt intervention; however, its pathogenesis remains elusive in most cases. Diabetes mellitus, a prevalent systemic metabolic disorder, has been increasingly implicated in the onset and unfavorable prognosis of SSNHL. Although epidemiological studies have consistently reported this association, the biological plausibility and causal direction of this relationship remain poorly understood and require further investigation. This review demonstrated that dysglycemia contributes to hearing impairment. The underlying mechanisms include vascular injury, auditory neuropathy, microcirculatory dysfunction, chronic inflammation driven by oxidative stress, and the accumulation of advanced glycation end products. Microcirculatory dysfunction may act as a critical nexus that integrates these diverse pathological pathways, ultimately leading to hearing loss. The potential role of prediabetes as an early driver of auditory damage, however, remains to be fully elucidated. Current management of SSNHL involves the use of glucocorticoids, vasodilators, neurotrophic agents, and adjunctive therapies, such as hyperglycemic control and hyperbaric oxygenation. Strengthening basic and translational research is essential to bridge mechanistic insights with clinical practice to develop precise therapeutic strategies to improve outcomes for patients with diabetes mellitus or prediabetes who present with SSNHL.
Core Tip: Growing evidence indicates that diabetes mellitus is not merely a comorbidity but an important contributor to sudden sensorineural hearing loss. Chronic hyperglycemia and early metabolic dysregulation lead to cochlear microvascular injury, neuropathy, oxidative stress, and impaired microcirculation, all of which increase susceptibility to hearing loss and hinder recovery. Emerging data suggest that prediabetes may already induce subclinical auditory damage. Elucidating these mechanisms provides a pathophysiological basis for risk stratification, early detection, and more individualized, mechanism-informed treatment strategies in patients with sudden sensorineural hearing loss.
