Diabetes and hearing loss are two of America's most widespread heath concerns. Nearly 26 million people in the US have diabetes, and an estimated 34.5 million have some type of hearing loss.

The numbers are similar - is there a link?

Yes, says the National Institute of Health (NIH). In fact, the NIH has found that hearing loss is twice as common in people with diabetes as it is in those who don't have the disease. Also, of the 79 million adults thought to have pre-diabetes, the rate of hearing loss is 30% higher than those with normal blood sugar.

How does diabetes contribute to hearing loss?

Hearing depends on small blood vessels and nerves in the inner ear. Researchers believe that, over time, high blood glucose levels can damage these vessels and nerves, diminishing the ability to hear.

I don't think I have any problems with my hearing.

Are you sure? For most people, hearing loss happens over time. The symptoms can be hard to notice. Quite often, family members and friends notice hearing loss before the person experiencing it.

Your doctor may not always screen for hearing loss during a physical. Even if your doctor does check for hearing loss, you may still "pass" the screening test in a quiet exam room. Common signs of hearing loss include:

• Frequent asking others to repeat themselves
• Trouble following conversations that involve more than two people
• Thinking that others are mumbling
• Problems hearing in noisy places such as busy restaurants
• Trouble hearing the voices of women and small children
• Turning up the TV or radio volume too loud for others who are nearby

I'm not even 65 - how could my hearing be bad already?

Most people with hearing loss are younger than 65. Hearing problems can even happen in children.

What should I do if I suspect a hearing loss?

Talk to your primary care doctor. You may then want to seek help from a hearing specialist like: an audiologist, a licensed hearing aid dispenser, or a doctor who specializes in hearing problems. From a full hearing exam, you'll learn more about your hearing loss. You will also be told what can be done to treat it.

What can be done to treat a hearing loss?

Sometimes the problem is just an earwax build-up and the patient is referred to a doctor to remove the wax. Treatment will depend on the type of hearing loss. The most common type of hearing loss is called "sensorineural hearing loss". This is the kind usually found with diabetes. It cannot usually be cured. However, most cases of sensorineural hearing loss can be treated with hearing aids.

How can I be sure that the hearing aids will help?

Hearing aids have changed a lot in the past few years. Instead of making all sounds louder, like the old kind, newer hearing aids are better at making what you want to hear more clear. These hearing aids also have special features. They may have automatic volume control and can reduce background noise.

But I don't want to be seen wearing hearing aids.

Hearing aids are getting smaller and smaller. It is unlikely anyone will notice when you are wearing them. The truth is, people are more likely to notice your hearing loss. People who don't treat their hearing problems can become depressed and try to avoid their friends. On the other hand, studies show that people who wear hearing aids often have a better quality of life.