ASSESSMENT OF HYPOGONADISM WITH REFERENCE TO CLINICAL FEATURES AND SERUM TESTOSTERONE LEVELS IN INDIAN MALE TYPE 2 DIABETICS AMONG PATIENTS ATTENDING DIABETIC CLINIC

Abstract

Objective: To Assess the prevalence of Hypogonadism with Reference to Clinical Features and Serum Testosterone Levels in Indian Male Type 2 Diabetics (T2DM)among patients attending Diabetic clinic in a rural medical college setup.

Material and methods: In the cross-sectional study of 50 diabetic patients of 30-66 years age group preferably without chronic illness, total testosterone, serum FSH, serum LH, HbA1c, Body Mass Index (BMI), Waist Circumference (WC) and Blood Pressure (BP) were measured. History of duration of diabetes, hypertension and smoking were also noted. Overt Hypogonadism was defined as the presence of clinical symptoms of hypogonadism and low testosterone level (total testosterone <2.31 ng/ml). Borderline hypogonadism was defined as the presence of symptoms and total testosterone of 2.31-3.46ng/ml.

Results: A low serum testosterone level was common in diabetic men and a significant proportion of these men had symptoms of hypogonadism. Overt hypogonadism was seen in 28% of men with total testosterone levels <2.31 ng/ml and borderline hypogonadism was found in 24% of men with total testosterone levels 2.31- 3.46 ng/ml. Total serum testosterone levels significantly and negatively correlated with both BMI (p <0.001) and WC (p = 0.025628), with the association being stronger for BMI. HbA1C also significantly and negatively correlated with serum testosterone levels (p <0.01). Significance was also noted with respect to hypertension (<0.001) and ADAM score(0.04528). Smoking and duration of diabetes did not have correlation with serum testosterone in our study.

Conclusions: Testosterone levels are frequently low in men with T2DM and the majority of these men have symptoms of hypogonadism, even in the younger age group (early-onset hypogonadism). Obesity and BMI are also associated with low testosterone levels in Indian diabetic men. Early recognition and treatment reduces the adverse effects on Metabolic and cardiovascular profile and restore sexual functions.

Keywords: Type 2 diabetes, serum testosterone, overt hypogonadism, obesity