Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 20

20 - PREVALENCE OF LOW TESTOSTERONE IN PATIENTS WITH TYPE 2 DM WITH ERECTILE DYSFUNCTION

Thursday, Apr 25
11:30 AM – 12:00 PM

Objective :

Background: Type 2 diabetes male patients are more likely to have low serum testosterone concentrations in comparisons with non-diabetics. In 43 cross-sectional comprising studies of 6427 male patients showed that type-2 diabetics had a mean serum testosterone concentration 76 ng/dL lower than non-diabetic men. The longitudinal studies showed that men who had higher testosterone concentrations had the lower risk of developing type 2 diabetes but the nature of the relationship is unclear and the association of testosterone, obesity, and insulin resistance couldn't be defined clearly. Studies over the last few years have clearly established that at least 25% of men with type 2 diabetes (T2DM) have subnormal free testosterone concentrations in association with inappropriately low LH and FSH concentrations.



Aim: this study was aimed to see the prevalence of low serum testosterone in type-2 diabetic patients and find the apparent cause.


Methods :

All male patients coming to tertiary care referral unit in the last week of August 2018 were asked to fill up the ADAM’s questionnaire for ED and were tested for S. Testosterone (chemiluminescence method) as per the routine clinical protocol for T2DM analysis. All baseline anthropometric data, clinical data and biochemical analysis were also carried out. Inclusion criteria were age between 35 to 65 years and T2Dm positive. All rest of the diabetics were excluded from the study. Patients with low testosterone were further evaluated for hypogonadism (Free testosterone, FSH, LH in morning pooled testosterone sample). Further the study population was divided into categories- Age- 35-50years; 50-65years, BMI- 27, Duration of Diabetes- 5years, A1c- 8%.


Results :

109 male patients were studied. Mean age was (53yrs). Patients with complain of ED (positive ADAM’s score) were 69. Patients with low testosterone were 11. Hypogonadism was detected in 4 patients out of these. Patients with ED in:



  1. Age- a. 35-50 – 24; b. 50-65 – 45

  2. BMI- a. <27-10; b. >27- 59; 

  3. Duration of Diabetes- a. 5years - 51

  4. A1c- a. <8%- 21; b. >8%- 48 


Discussion :

ED in T2DM patients seems more to be correlated with the age, BMI, duration of diabetes and glycemic status rather than hypogonadism. Further statistical analysis is being carried out.


Conclusion :

Erectile dysfunction and low testosterone in Type 2 DM do not necessarily corelate which means that there are numerous factors affecting the erectile dysfunction in males with T2DM. This small study shows that if studied in a larger population we can definitely find the factors out. 

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Banshi D. Saboo

Chief Diabetologist
Diacare- Diabetes Care & Hormone Clinic

Chief Diabetologist with primary interest in prevention of diabetes

Dhruvi Hasnani

Diabetologist
Diacare- Diabetes Care & Hormone Clinic

Diabetologist

Shashank Joshi

Senior Endocrinologist
Lilavati and Bhatia Hospital
Mumbai, Maharashtra, India

Prof Shashank R. Joshi MD, DM, FACP, FACE, FRCP
Endocrinologist, Lilavati & Bhatia Hospital
Consultant and Advisor, Apollo Sugar Clinics
President, Indian Academy of Diabetes, Past President, Endocrine Society of India
Past President, Research Society for Study of Diabetes in India(RSSDI)
Past President, All India Association for Advancement of Research in Obesity Past President, Association of Physicians of India, Emeritus Editor, JAPI
Indian Chapter Chair, AACE
He was honored by the Government of India, in 2014, by bestowing on him the Padma Shri, the fourth highest civilian award, for his services to the field of medicine. He is also a recipient of the International Clinician Award, received at the 21st American Association of Clinical Endocrinologists (AACE) Annual Scientific and Clinical Congress, Philadelphia. This is an annual award given to practicing endocrinologists, outside the US

Sunil Gupta

Diabetologist
Diabetes Care n' Research Centre, Maharashtra, India

Consultant Diabetologist since 25 Years,Fellow of American College of Physician,FRCP Glasgow,National Executive council member in Research Society for Study of Diabetes in India.

Sudhir Bhandari

Diabetologist
SMS University, Jaipur

Diabetologist

Anuj Maheshwari

Head and Professor Medicine
BBD University, Lucknow, Maharashtra, India

Diabetologist and professor of Medicine at Lucknow.

Sandeep Tak

Professor
SN Medical College, Jodhpur, India
Jodhpur, Rajasthan, India

Consultant Diabetologist Physician & Professor of Medicine