Protecting Your Voice

Most people take their voice for granted — until they develop laryngitis, for example, and talking becomes a struggle. Recently, I was writing a piece for health coaches about how to protect the voice, and I wondered if there was any connection between having diabetes and vocal problems. While not as common as other issues or complications, the loss of one’s voice or difficulty talking can be related to poor blood sugar control and/or diabetic neuropathy.

What happens when you lose your voice
Sound is produced when your vocal cords, which are two bands of smooth muscle tissue in your larynx (voice box), vibrate. If you’ve lost your voice (meaning, you’re unable to talk), it means that your vocal cords aren’t working properly. Typically, this happens due to inflammation or infection, which cause vocal folds to swell, preventing the vibration that is necessary to speak. Nervous system disorders and obstructions, such as a tumor, can affect your vocal cords, too.

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Diabetes as a cause
A study published in 2012 in the journal European Archives of Oto-Rhino-Laryngology (how’s that for a journal name?) found that, compared to a control group, subjects with Type 2 diabetes with poor glycemic control and with neuropathy had more straining and voice weakness, and also a significant difference in the grade of their voices. Chronic inflammatory polyneuropathy, or peripheral neuropathy, which affects nerves outside of the brain and spinal cord, can lead to a host of problems, such as difficulty walking, facial weakness, numbness in the hands and feet, difficulty swallowing, and hoarseness or changes in the voice.

Other causes
Diabetes isn’t the only cause of difficulties with one’s voice. There are a whole host of possible culprits, which include:

• Acid reflux
• Allergies or an allergic reaction
• Cancer of throat or larynx
• Chronic coughing
• Colds or upper respiratory infections
• Inhaling fumes from toxic chemicals
• Smoking
• Heavy drinking
• Growths or nodules on the vocal cords due to overuse of the voice
• Thyroid issues
• Breathing problems
• Neurological disorders (multiple sclerosis, Parkinson’s disease, ALS)
• Stroke

Symptoms of voice problems
Obviously, completely losing your voice — or, the inability to talk — is a problem, especially if you rely on your voice for your job, for example. If laryngitis is the culprit due to, say, a bad cold or screaming at a football game or concert, your voice is likely to come back with a bit of vocal rest. But you might have other symptoms that can indicate a vocal problem, such as:

• Hoarseness that doesn’t improve after two weeks
• Trouble swallowing
• Having a lump in your throat
• Throat pain
Changes in your voice (e.g., your voice sounds deeper) that last longer than three weeks
• Swollen lymph nodes that last more than two or three weeks after an infection
• Coughing up blood
• A high temperature for more than two days

See your doctor if you have any of these symptoms.

Keep your voice healthy
There are steps that you can take to make sure that your voice stays in top shape. If you have diabetes, it probably goes without saying that aiming to keep your HbA1c and blood sugars in your target range is a key goal. Here are some other steps you can take, as well:

• Stay hydrated by drinking plenty of water or non-caffeinated liquids.
• Limit beverages that contain caffeine or alcohol, as they can be drying to the throat.
• Use a humidifier in your home, especially in the winter.
• Don’t smoke.
• Try not to clear your throat, which can damage your vocal cords. Sip on water, instead.
• Sit up straight, especially when you’re talking on the phone.
• Steer clear from smoky grills or places where there is smoke or chemical fumes.
• Avoid yelling and screaming, even if your favorite team is winning.
• If you’ve had a cold or a respiratory infection, try to rest your voice as much as possible, especially if you’re already hoarse. Trying to talk will just make your hoarseness worse.
• Get enough sleep.
• If you have to talk frequently during the day, try to rest your voice at night.

Any vocal problems that last for more than a week or two should be reported to your doctor for further evaluation. He or she may refer you to a specialist, such as a laryngologist, who can look at your voice box and do further testing. Depending on the diagnosis, treatment may include medication, injections, surgery, or sessions with a speech pathologist or vocal coach (voice therapy).

For more information about vocal disorders and treatments, visit The Voice Foundation’s website.

A year after being diagnosed with depression, Amy Mercer finds herself in a very different place. Bookmark DiabetesSelfManagement.com and tune in tomorrow to read more.

  • Dr. Shahriar Mostafa

    Diabetes may effect your voice, a new thing i learned today. Diabetes causes so many complications when uncontrolled. And controlling it is easy. Knowledge is the key to win over diabetes, and you should never stop Learning.

  • RAWLCM

    Very interesting. For a few years I have been suffering a dry, scratchy throat and increasing raspy tone in my voice. It was assumed to be due to gastric reflux. I was not aware this was a potential complication from diabetes.