Hypogonadism and diabetes mellitus - Implications for cardiovascular risk

Excerpt

It is well recognized that hypogonadism is common in diabetes mellitus (DM) [1‐3]. However, most of the earlier reports have been in the context of sexual dysfunction particularly resulting in erectile dysfunction (ED) in diabetic men [2]. While ED is an important cause of morbidity in these individuals, there could be other health consequences that also require urgent attention. Testosterone deficiency can affect several facets of the well-being of diabetic patients including sexual performance, mental health, and quality of life [4]. More recently, studies have also focussed on issues that could impact the cardiovascular (CV) and bone health of those affected with DM. Several studies have suggested that hypogonadism particularly in diabetic men is associated with insulin resistance (IR) [5] and a higher occurrence of metabolic syndrome [6]. Clamp studies in patients of DM with testosterone deficiency have revealed a significant reduction in insulin-mediated glucose uptake that has been shown to improve with gonadal hormone replacement in these hypogonadal individuals [7]. These observations suggest that hypogonadism could be associated with significant CV risk among diabetic subjects. …