Endocrine Abstracts

Introduction: Hypogonadism (HG), a condition characterized by low levels of testosterone, is a common issue in men, particularly those with type 2 diabetes (T2D). The relationship between glycemic control and HG has been a topic of interest in recent years. In this study, we aimed to investigate the influence of glycemic control on HG.

Methods: This is a descriptive cross-sectional study involving 250 men with T2D aged 40 to 65 years, followed in outpatient consultations. All patients underwent both metabolic and hormonal assessments. Glycemic control was defined based on the criteria outlined by the American Diabetes Association (ADA) in 2022, while the diagnosis of HG was determined according to the criteria established by Vermeulen [1].

Results: The median age (IQR) of men with HG was 59 years [56-64], with a prevalence of 27.2% (n=68). The mean duration of diabetes was 12.5±7.4 years [Range: 1-31], more than half of the patients (62.2%) had over 10 years history of type 2 diabetes. The mean fasting glucose level was 10.9±4.3 mmol/l [Range: 3.2-25.8]. The mean HbA1c was 9±1.7% [Range: 5.6-14.5], and glycemic control was achieved in only 21.6% of patients. Comparatively, the mean duration of diabetes between the HG and non-HG groups was nearly identical (13.0±7.3 vs 12.4±7.5 years; P=0.594). Additionally, the mean fasting glucose levels were comparable between the two groups, HG and non-HG (10.9±4.2 vs 11.0±4.4 mmol/l; P=0.827). However, a significant association was found between HbA1c and the prevalence of HG (P= 0.044). The mean HbA1c values were 9.4±1.8% and 8.9±1.6% for the HG and non-HG groups, respectively. In terms of glycemic imbalance, it was more frequent in patients with HG, with percentages of 85.1% compared to 75.8% in the non-HG group, although this difference did not reach statistical significance (P=0.083).

Conclusion: In conclusion, our study highlights the importance of monitoring and optimizing glycemic control, especially inT2D men, as it may play a role in the development or exacerbation of HG. Future research should thoroughly investigate the causal relationship between glycemic control and HG, considering additional factors that may contribute to this association.

Reference: 1. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999; 84(10):3666-3672. doi:10.1210/jcem.84.10.6079