If you have diabetes, experts recommend getting your hearing checked, as new research shows hearing loss is twice as common in adults with diabetes.

“Hearing loss may be an under-recognized complication of diabetes. As diabetes becomes more common, the disease may become a more significant contributor to hearing loss,” says Catherine Cowie, PhD, senior researcher at the National Institute of Diabetes and Digestive and Kidney Diseases.

In hearing tests among a random sampling of more than 5,000 Americans, hearing loss was noted across all sound frequencies—especially high-pitched sounds—in people with diabetes. And if your healthcare provider has told you that your blood sugar is borderline high but not quite into the range for a diabetes diagnosis, you’re still at risk for hearing loss from pre-diabetes.

Diabetes may cause hearing loss by damaging the nerves and blood vessels of the inner ear, according to the study, which was recently published in the Annals of Internal Medicine. Autopsies among people who had diabetes have shown evidence of such damage.