HYPOTHESIS Veterans with diabetes will have significantly greater hearing loss than nondiabetic veterans. BACKGROUND The association between diabetes and hearing loss remains unclear despite the volume of research that has been devoted to the question. Often, differences in hearing thresholds between diabetic and nondiabetic patients are confounded by age and noise exposure. METHODS In this 5-year prospective study, 342 diabetic veterans and 352 nondiabetic veterans from the Portland VA Medical Center in Oregon were tested on a variety of audiometric measures, including pure-tone thresholds. RESULTS Age and noise exposure were accounted for in the analyses. There was a trend toward greater hearing loss in diabetic patients 60 years of age and younger across the frequency range. These differences were statistically significant only in the highest frequencies tested (10, 12.5, 14, and 16 kHz). The effects of both diabetes and noise exposure on high-frequency hearing thresholds were dependent on age. For patients older than 60 years, the mean thresholds were not significantly different. CONCLUSION These results suggest that diabetic patients 60 years old or younger may show early high-frequency hearing loss similar to early presbycusis. After age 60, difference in hearing loss between diabetic and nondiabetic patients was reduced.