Type 2 diabetes mellitus (T2DM) has been associated with sensorineural hearing loss through microvascular and neural pathways. Although T2DM prevalence is high in Saudi Arabia, limited research has examined the relationship between glycemic control and auditory function in this population.

To investigate the association between glycated hemoglobin (HbA1c) levels and hearing threshold levels (HTL) in Saudi adults with T2DM.

This retrospective cross-sectional study analyzed medical records of 41 Saudi adults with T2DM (aged 20–57 years, 27 males, 14 females) who underwent pure tone audiometry and HbA1c testing at Royal Commission Medical Center, Yanbu, between 2021–2024. Linear regression analyses examined associations between HbA1c and HTL across low-frequency (0.25–2 kHz) and high-frequency (4–8 kHz) ranges.

Mean participant age was 49.1 ± 7.8 years, with mean HbA1c of 6.9 ± 1.2 %. Linear regression revealed significant positive associations between HbA1c and HTL in both low-frequency (β = 0.93, 95 % CI: 2.30–2.98, p < 0.001) and high-frequency ranges (β = 0.91, 95 % CI: 4.05–5.46, p < 0.001). Age was also significantly associated with HTL in both frequency ranges ( p < 0.001).

Elevated HbA1c levels are significantly associated with increased hearing thresholds in Saudi adults with T2DM, suggesting that poor glycemic control may contribute to auditory dysfunction. These findings support incorporating routine audiological assessments into diabetes care protocols.