Sudden Hearing Loss Recovery With Diabetes Case Study

A 56-year-old woman with severely uncontrolled type 2 diabetes experienced a full recovery from sudden hearing loss, despite receiving a high-dose steroid treatment that dramatically spiked her blood sugar. The case, documented by Indonesian researchers Ni Made Pasmiati Setyaningsih and Ni Putu Oktaviani Rinika Pranitasari, suggests that with careful monitoring, standard emergency treatment for hearing loss may be possible even in high-risk patients.

The Treatment Dilemma: Steroids and Uncontrolled Diabetes

Sudden sensorineural hearing loss is an otologic emergency. It is defined as a drop in hearing of at least 30 decibels across three neighboring frequencies, occurring within a 72-hour window. The standard first-line treatment is a high-dose corticosteroid, like methylprednisolone, to reduce inner ear inflammation. However, a major side effect of these drugs is hyperglycaemia—they make blood sugar levels rise.

This creates a significant problem for patients with type 2 diabetes mellitus (T2DM), which is itself a recognized risk factor for SSNHL and often leads to worse recovery outcomes. Doctors face a dilemma: withhold the most effective treatment due to diabetes, or risk dangerous blood sugar spikes. The case study presents one team’s approach to this challenge.

Managing Extreme Hyperglycaemia Without Stopping Treatment

The patient was a 56-year-old woman with a history of severely uncontrolled T2DM, indicated by a hemoglobin A1c level above 14%, and hypercholesterolaemia. She presented to hospital two days after losing hearing in her right ear. Audiometry confirmed a moderate-to-severe SSNHL.

Her medical team proceeded with the standard protocol: a 15-day taper of intravenous methylprednisolone. They simultaneously started her on five sessions of hyperbaric oxygen therapy and a statin for her cholesterol. Critically, an endocrinologist was involved from the start to manage a basal-bolus insulin regimen.

As expected, the steroids caused severe hyperglycaemia. The patient’s capillary glucose exceeded the upper limit of the glucometer (500 mg/dL) on four separate days, with the highest measured value being 496 mg/dL. Instead of reducing or discontinuing the corticosteroid—which could jeopardize hearing recovery—the team intensified her insulin therapy. No clinical hyperglycaemic crisis, such as diabetic ketoacidosis, occurred.

Complete Hearing Recovery Against the Odds

The outcome was successful. The patient’s hearing thresholds returned to normal by the seventh day of treatment. Her hearing remained normal when re-tested on day twelve, meeting the criteria for complete recovery. This is a notable result given that poorly controlled diabetes is typically associated with poorer prognosis in SSNHL.

The authors, Setyaningsih and Pranitasari, are careful to note that a single case cannot establish a causal link between the treatment package and recovery. The patient had several favourable prognostic factors, such as starting treatment early and having moderate-to-severe (rather than profound) hearing loss. The positive result may also relate to the additional therapies like hyperbaric oxygen, which is sometimes used as a salvage treatment. You can read more about pressure-based therapies in our article on Pressure Therapy for Bilateral Ménière’s Disease.

Practical Implications for Hearing and Diabetes Care

This case report offers a practical framework for a common clinical conflict. The core finding is that full-dose corticosteroid treatment for SSNHL appears feasible even in patients with severely uncontrolled T2DM, provided specific support systems are in place.

Two elements were vital. First was structured glucose monitoring, with frequent checks allowing for rapid response. Second was immediate endocrinology collaboration to aggressively manage insulin in real-time. This interdisciplinary approach prevented a hyperglycaemic emergency while allowing the ear-targeted treatment to continue.

For patients with hearing disorders who also have systemic conditions like diabetes, coordinated care is essential. Understanding the broader links between systemic and auditory health is important; for instance, research also explores connections between temporomandibular disorders and hearing problems.

A Model for Integrated Treatment

The report does not suggest that high-dose steroids are safe for all diabetic patients. It does, however, provide a documented model where it was successfully and safely administered under rigorous conditions. This can inform clinical decision-making when the alternative—withholding steroids—may condemn a patient to permanent hearing loss.

For individuals concerned about hearing health, this case underscores the importance of managing overall systemic conditions. Diabetes can affect multiple aspects of health, including subtle auditory nerve function. Proactive management of blood sugar may be a form of hearing preservation.

The full case report, “Corticosteroid therapy in sudden sensorineural hearing loss patient with uncontrolled type 2 diabetes mellitus: A case report,” is available in the International Journal of Public Health Science (DOI: 10.38035/ijphs.v4i3.2267).