Hearing Health Monitoring in Adults Living with Diabetes: A Scoping Review to Inform Integrated Care Pathways.

Objectives: Diabetes is a significant risk factor for hearing loss, highlighting the need for evidence-informed hearing health monitoring. Undiagnosed and untreated hearing loss can impair communication, reduce participation in daily activities, and diminish quality of life. This scoping review synthesized the current evidence on hearing loss screening and assessment in adults living with diabetes and identified knowledge gaps to inform the development of an evidence-informed hearing health monitoring framework. Design: A scoping review was conducted in accordance with the Joanna Briggs Institute methodology. Seven electronic databases were searched for peer-reviewed studies reporting primary data on the relationship between diabetes and hearing loss. Results: A total of 201 studies met the inclusion criteria. The literature represented a global evidence base, with studies conducted across diverse settings, including hospitals, community and diabetes clinics, schools, audiology clinics, outpatient clinics, and research centres. Pure-tone audiometry was the most frequently used assessment, followed by electrophysiological measures and otoacoustic emissions. Fewer than half of the studies provided recommendations for hearing screening, assessment, or monitoring, and only six advocated for early referral to hearing healthcare services. Conclusions: Despite growing evidence linking diabetes and hearing loss, important gaps remain in recommendations for diagnostic assessment, hearing health monitoring, referral pathways, and interdisciplinary integration within diabetes care. The findings of this review provide a foundation for developing an evidence-informed hearing health monitoring framework and support the integration of hearing health into coordinated person-centred diabetes care pathways.