The Not So Well-Known Co-morbidities of Diabetes

diabetes ear mouth bone2

By: Jacqueline Minichiello, MS, RD, LDN
Clinical Nutritionist at Neponset Health Center/WIC

Most people know that diabetes affects parts of the body including the nerves, the kidneys, the eyes and feet. However, there are other co-morbidities of diabetes that are not as well known, but can similarly impact a patient’s health. Here is a summary of those:

Hearing loss

• Autopsies have revealed damage to nerves and blood vessels of the inner ear in humans with diabetes.

• Data analysis of the NHANES data from 1999-2004 showed that diabetes more than doubles the rate of hearing loss. Also, the severity of hearing loss increases with the progression of diabetes.

• Tips to ensure that you are able to hear all your provider has to say:

o If you cannot hear let the provider know

o Ask the provider to speak clearly, but normally

o Sit close to the provider and ask them to face you directly

Oral Health

• Periodontal disease is associated with poorer glycemic control and people with diabetes who have poor glycemic control are at higher risk of periodontitis.

• People with diabetes need to make dental screenings a priority in their healthcare.

• Some of the reasons to speak with your doctor are if:

o You cannot consume food due to mouth pain

o You have obvious facial swelling

o You have complaints of recurrent mouth ulcers, etc.

Bone Health

• People with diabetes have a higher incidence of bone fracture compared to the general population.

• The reason for this is not yet clear, but researchers have found that those with diabetes for 5 years or more have the lowest bone mineral density (BMD).

• While a low BMD is found in patient with Type 1 Diabetes, in patients with Type 2 Diabetes a higher BMD is found. However, this is not necessarily protective against fractures.

• Some theories include:

o Impaired vitamin D metabolism with kidney disease and decreased blood supply to the bone

o Increase in falls due to impaired eyesight and decreased balance related to neuropathies

• Bottom line: achieve adequate calcium and vitamin D, blood glucose control, and talk with your doctor regarding the risk of osteoporosis and diabetes.

Jaqueline Minichielo 3      Jacqueline Minichiello, MS, RD, LDN

Jackie is a registered dietitian with a master’s degree in nutrition from Tufts University. She has a passion for cooking, food and physical activity.

Check out these other articles by Jackie!

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