The growing prevalence of diabetes mellitus poses great challenges to health care systems worldwide. In addition to wellknown DM-related complications, more evidence regarding the detrimental effect of DM on the auditory system has arisen in recent years. Such auditory dysfunction can affect the peripheral as well as the central auditory system. Based on recent research, potential pathogenic mechanisms associated with DM-related hearing impairment can be metabolic and microangiopathic. However, there is no consensus on which of these pathogenic mechanisms is the most prevalent. Specialists who are in close contact with diabetics should be aware of the potential auditory dysfunction within this patient population, and to ensure that affected patients are informed of available treatment options.