This study aimed to determine the prevalence of undiagnosed diabetes and prediabetes in patients presenting with recurrent otomycosis and to evaluate associated risk factors, fungal profiles and cerumen pH variations.

This cross-sectional study included 213 adults with greater than or equal to two episodes of otomycosis. Glycaemic status was assessed using fasting blood sugar, post-prandial blood sugar and glycated haemoglobin. Fungal identification and cerumen pH measurement were performed. Multivariate analysis identified predictors of recurrence.

Undiagnosed diabetes and prediabetes were found in 30 per cent and 13 per cent of patients, respectively. Candida albicans predominated in diabetics, while Aspergillus niger was common in normoglycaemics. Cerumen pH was significantly higher in diabetics (6.6) compared to normoglycaemics (5.3). Glycated haemoglobin greater than or equal to 6.5 per cent, Candida infection and steroid ear drop use were independent predictors of recurrence.

A substantial proportion of patients with recurrent otomycosis harbour unrecognised glycaemic abnormalities. Routine diabetes screening in ENT clinics may aid in early metabolic disease detection and reduce recurrence rates.