Prevalence of phonatory symptoms in patients with type 2 diabetes mellitus

Acta Diabetologica, 05/10/2012

Hamdan AL et al. – Diabetic patients are more likely to have phonatory symptoms compared to controls, namely straining and hoarseness. One out of seven patients with diabetes has reported that phonatory symptoms had a significant impact on their quality of life. The presence of neuropathy and poor glycemic control should alert the treating physician to these vocal complaints.


  • A total of 105 consecutive patients diagnosed with type 2 diabetes mellitus by their primary endocrinologist were evaluated.
  • A control group consisting of 33 healthy subjects was recruited for this study.
  • Demographic data included: age, gender, allergy, smoking, duration of the disease, glycemic control, and presence or absence of neuropathy.
  • Subjects were also asked about the presence or absence of the following symptoms: hoarseness, vocal tiring or fatigue, vocal straining, and aphonia or complete loss of voice.
  • Patients were also asked to fill out the Voice Handicap Index 10.


  • The mean age of patients with diabetes was 53.21 + 9.68 years with male-to-female ratio of 2/3.
  • The most common phonatory symptoms were vocal tiring or fatigue and hoarseness (34.3 and 33.3 %).
  • There was a significant difference in the prevalence of hoarseness and vocal straining (p value 0.045 and 0.015, respectively) compared to controls.
  • There was a significant correlation between glycemic control, neuropathy, and hoarseness (p value 0.030 and 0.001, respectively).
  • Vocal straining and aphonia also correlated significantly with the presence of neuropathy.
  • Close to 16 % of diabetic patients had a VHI-10 above or equal to 7.

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