Serum testosterone in males with newly diagnosed type 2 diabetes mellitus and microvascular complications

Background: The role of testosterone in the pathogenesis of metabolic syndrome and diabetes mellitus has been well documented. Low testosterone levels have been associated with an increased risk of insulin resistance and type 2 diabetes mellitus (T2DM) and testosterone supplementation has been found to reduce insulin resistance and blood glucose levels. However, there is limited data available regarding the influence of testosterone levels on microvascular complications in patients with diabetes. This study was undertaken with the objective of evaluating levels of serum testosterone in newly diagnosed male patients with T2DM and to correlate serum testosterone levels with microvascular complications.

Materials and Methods: A single point cross sectional case-control study was conducted at MLN Medical College, Allahabad and its associated SRN Hospital, Allahabad from March 2013 to July 2014. 168 males between 18-60 years of age were recruited for the study. From these patients, 83 patients who were diagnosed with T2DM during the last 3 months were considered as cases and remaining 85 patients without diabetes were taken as controls. Detailed history was obtained and clinical examination was performed. Serum low testosterone was defined as total testosterone<241 ng/dl and the prevalence of its deficiency was calculated. The values of serumtestosterone were correlated with microvascular complications of diabetes viz. neuropathy, retinopathy and nephropathy.

Results: Out of the 83 patients of T2DM, low serum testosterone was found in 37(44.58%) while it was present in only 10(11.8%) of 85 controls, which was statistically significant (χ2 = 20.84, df =1, p <0.0001). Microvascular complications were seen in 25(67.56%) patients with low testosterone while only 4(8.7%) patients had microvascular complications with normal testosterone level which was statistically significant (p<0.0001).

Conclusions: Prevalence of hypogonadism was significantly (P<0.0001) higher in T2DM patients compared to controls. Subjective evidence of hypogonadism and microvascular complications were observed more frequently in patients with low testosterone compared to normal testosterone.