Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study
Open accessAbstract
BACKGROUND: A high prevalence of low serum testosterone (LST) in men with type 2 diabetes have been reported worldwide. The aim of this study was to determine the prevalence and associated factors of LST in men with type 2 diabetes. MATERIALS AND METHODS: This was a cross-sectional study, conducted among 1,089 men (aged 30-70 years) with type 2 diabetes who consecutively attended a major diabetes center in Amman, Jordan, between August 2008 and February 2009. The patients' demographic characteristics were collected using a prestructured questionnaire. Duration of diabetes, smoking habits, presence of retinopathy, neuropathy, and nephropathy were collected from the medical records. All participants were asked to complete the Androgen Deficiency in Ageing Male (ADAM) questionnaire. Venous blood sample was collected to test for total testosterone (TT), free testosterone (FT), sex hormone binding globulin (SHBG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), serum lipids, and glycosylated hemoglobin (HbA1c). LST was defined as TT <3 ng/ml. RESULTS: Overall, 36.5% of patients with diabetes had TT level <3 ng/ml and 29% had symptoms of androgen deficiency. Of those with serum testosterone level <3 ng/ml, 80.2% had symptoms of androgen deficiency, 16.9% had primary hypogonadism (HG), and 83.1% had secondary HG. Univariate analysis showed a significant relationship between age, income, education, body mass index (BMI), smoking, duration of diabetes, diabetic nephropathy, diabetic neuropathy, and HbA1c. Multivariate logistic regression analysis indicated age, income, BMI, and diabetic neuropathy as the independent risk factors of LST. CONCLUSIONS: The prevalence of LST among men with type 2 diabetes is high. Age, income, BMI, and diabetic neuropathy were found to be the independent risk factors for LST.
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Men with a history of unexplained anemia, bone density loss, diabetes, exposure to chemotherapy, direct or scatter radiation therapy to the testes, HIV, chronic narcotic use, infertility, pituitary disorders, or chronic corticosteroid use are at risk for low testosterone.
“A meta-analysis of the literature suggests that men who have a history of unexplained anemia, 7 bone density loss, 8 diabetes, 9 exposure to chemotherapy, 10 direct or scatter radiation therapy to the testes, 11 HIV, 12 a history of chronic narcotic use, 13 infertility, 14 pituitary disorders, 15 and chronic corticosteroid use 16 are at risk for low testosterone.”
From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [9]
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Evaluation and Management of Testosterone Deficiency: AUA Guideline
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- Authors
- Al Hayek, A., Khader, Y., Jafal, S., Khawaja, N., Robert, A., & Ajlouni, K.
- Affiliations
- National Center for Diabetes, Endocrinology and Genetic Diseases (JO)
- Venue
- Journal of Family and Community Medicine
- Published
- 2013
- Volume
- 20
- Issue
- 3
- Pages
- 179
- ISSN
- 1319-1683 (ISSN-L)
- 2230-8229
- PMC
- PMC3957172
- OpenAlex
- W2025989795
- Cited by
- 94
- References
- 49
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 3 · 2022: 9 · 2021: 9 · 2020: 5 · 2019: 11 · 2018: 10 · 2017: 9 · 2016: 12 · 2015: 7 · 2014: 1
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Family and Community Medicine (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- androgen deficiency, type 2 diabetes, hypogonadism, prevalence, risk factors, diabetic neuropathy, body mass index, age, income, smoking, diabetic nephropathy, sex hormone-binding globulin
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