Nearly all systems in the body are affected by the metabolic disarrangement of diabetes mellitus. Consequently, a serious signaling pathway may develop that can potentially lead to several adverse complications. Diabetic otopathy (DO) is a clinical syndrome characterized by hearing impairment due to the toxic effect of diabetes mellitus. Evidence-based studies have indicated a significant relationship between vestibular and/or auditory disorders and diabetes mellitus. A screening test for DO has been suggested in all diabetic patients with long-standing disease. Further clinical trials are warranted to explore the molecular mechanisms of DO.