Prevalence & Determinants of Low Testosterone Levels in Men with Type 2 Diabetes Mellitus Presenting to a Tertiary Care Hospital

Abstract

Introduction: The association between Type 2 Diabetes Mellitus (T2DM) and male hypogonadism is increasingly recognized. However, data regarding its prevalence and determinants remain limited in certain populations. Understanding this relationship is essential for improving comprehensive diabetic care and addressing associated complications such as erectile dysfunction and reduced quality of life.
Aim & Objective: The study aimed to assess the prevalence and determinants of low testosterone (LowT) in men with Type 2 Diabetes Mellitus (T2DM). It included evaluation of erectile dysfunction (ED) using the SHIM scale, identification of potential predictors such as body mass index (BMI) and lifestyle factors, and determination of the association between diabetic status and testosterone levels.
Materials & Methods: A cross-sectional study was conducted over 18 months at a tertiary care hospital in Chennai. A total of 329 patients with T2DM were recruited using purposive sampling. Data collection included demographic details, clinical history, and assessment of erectile dysfunction using the SHIM questionnaire. Laboratory investigations measured serum total, free, and bioavailable testosterone levels. Statistical analysis was performed using SPSS version 21.
Results: The prevalence of LowT was 74.8%. Erectile dysfunction was observed in 94.2% of participants, with severity significantly associated with LowT (p < 0.001). No significant associations were found between LowT and age, occupation, smoking, alcohol consumption, physical activity, BMI, or glycemic parameters (fasting plasma glucose and HbA1c). However, strong associations were noted between LowT and psychological, somatic, and sexual symptom severity (p < 0.001). Waist circumference showed a trend toward association (p = 0.068).
Conclusion: There is a high prevalence of hypogonadism and erectile dysfunction among men with T2DM. Testosterone deficiency is strongly associated with symptom severity but not with conventional metabolic or lifestyle factors alone. Routine screening for hypogonadism should be incorporated into the management of diabetic men to improve overall quality of life.