Central auditory processing abilities in Type 2 Diabetes Mellitus - An exploratory study

1. Title: Central Auditory Processing Abilities in Type II Diabetes Mellitus – An Exploratory Study

2. Type of Study: Prospective, cross-sectional study

3. Aims & Objectives

Primary Objective: Explore and compare auditory processing abilities in individuals with Type 2 Diabetes Mellitus (T2DM) and without diabetes.

Secondary Objective: Investigate the relationship between auditory processing, cognitive abilities, and lifestyle (noise exposure) in T2DM patients.

4. Justification: Existing studies by Workman et al. (2017) and Pirasteh et al. (2018) indicate deterioration in auditory processing abilities among individuals with T2DM, but comprehensive understanding is lacking. This study aims to bridge this gap, highlighting how cognitive impairments associated with T2DM affect auditory processing, essential for better management strategies.

5. Departments Involved:

• Center for Podiatry & Diabetic Foot Care & Research, MAHE
• Department of Speech and Hearing, MCHP, MAHE

6. Study Period:

• Reviews and approvals: 2-3 months
• Data collection: June 2024 – February 2025
• Analysis and manuscript submission: March 2025

7. Sample Size:

• Total: 62 participants (31 T2DM, 31 control)
• Calculated using power study and significance level parameters from Mishra et al. (2016)

8. Materials and Methods:

• Inclusion Criteria:

• T2DM Group: Aged 45-60, native Kannada speakers, mild hearing loss, minimum 2 years T2DM duration, HBA1c > 6.5%

• Control Group: Aged 45-60, native Kannada speakers, mild hearing loss, no diabetes

• Exclusion Criteria:

• T2DM Group: Neuropathies, hypertension, early dementia, ototoxic drug intake, treatment with insulin/oral hypoglycemic agents

• Control Group: Hypertension, early dementia, ototoxic drug intake

• Statistical Methods:

• Data analysis using SPSS or Jamovi

• T-tests, correlation analysis, MANOVA to compare auditory processing tests controlling for age, noise exposure, and cognitive ability

• Tools:

• Noise Exposure Questionnaire (NEQ) by Tiffany et al. (2017)

• Montreal Cognitive Assessment (MoCA) by Nasreddine et al. (2005)

9. Procedure: Participants will be recruited from specified centers, screened based on criteria, and undergo auditory processing tests (SPIN, ATTR, PPT, DDT). NEQ and MoCA questionnaires will assess noise exposure and cognitive abilities for the T2DM group. The entire procedure will last 45 minutes to 1 hour, with breaks as needed. Data will be analyzed to compare performances between T2DM and control groups.

10. Outcome Measures:

• Scores for DDT, ATTR, PPT
• SNR loss for SPIN test
• Noise exposure and cognitive decline scores from questionnaires

11. Risks and Benefits:

• Risks: Minimal, primarily discomfort due to the procedure duration
• Benefits: Participants receive information on auditory processing, cognition, and hearing levels, contributing to better understanding and management strategies

12. Ethical Considerations:

• Clearances from IEC, IRC, and CTRI
• Informed consent obtained from participants
• Confidentiality maintained
• Data reviewed only by authorized personnel

13. Budget and Funding: Not applicable

14. Literature Review:

Research indicates a higher likelihood of hearing loss and cognitive impairments among T2DM individuals, affecting their quality of life

Studies by Mishra et al. (2016), Yaffe et al. (2020), Srikanth et al. (2020), and Moheet et al. (2015) show poor performance in temporal resolution tasks and other cognitive domains among diabetic patients.

This study aims to fill the research gap by considering multiple covariant factors together, enhancing understanding of the complex interactions between T2DM and auditory processing.