A study to know the serum total testosterone levels in type II diabetes mellitus male patients from North India

Saurabh Agarwal, Brijesh Kumar, Sushmita ., Richa Giri, Sanjay Kumar Verma


Background: Diabetes mellitus is major public health issue facing the world in present century and the prevalence of type 2 diabetes is increasing explosively.  There are various diabetes related complications, one of which is low testosterone levels in men. This study was designed to estimate the serum testosterone level in male patients of type 2 diabetes mellitus.

Methods: The patients of type -2 diabetes mellitus were picked up from out-patient and in-patients section of the hospital at random.

Results: Seventy male  patients with type 2 diabetes mellitus were enrolled during the study period. The mean age of study population was 56.36±10.26 years (range 36-70), while that of control group patients was found to be 39.80±7.92years. Family history of diabetes was present in 14 (22.2%) patients. The mean HbA1c in study group was 8.83±1.95 %, which was significantly higher as compared to control group with HbA1c 4.82±0.40 %. Among study group, lower serum total testosterone level was observed in 85.7 % cases and normal level in 14.3 % cases. Among control group, lower serum total testosterone level was observed in 6.7 % cases and normal level in 93.3 % cases.

Conclusions: The present study highlighted that significant difference in serum total testosterone level has been observed between cases and control groups (X2 =55.7, P=0.0001).


Diabetes mellitus, Testosterone, Family history

Full Text:



New Zealand guidelines Group. Management of type 2 diabetes: Evidence-based best practice guideline. 2003 New Zealand Guidelines Group. Available at:

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.

Joshi SR, Parikh RM. India - diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323-4.

United Kingdom prospective diabetes study (UKPDS) 13: relative efficacy of randomly allocated diet, sulphonylurea, insulin or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. Brit Med J. 1995;310:83-8.

Fukui M, Soh J, Tanaka M, Kitagawa Y, Hasegawa G, Yoshikawa T, et al. Low serum testosteroneconcentration in middle-aged men with type 2 diabetes. Endocrine J. 2007;54:871-7.

Grossman M, Thomas MC, Panagiotopoulos S, Sharpe K, Maclsaac RJ, Clarke S, et al. Low testosterone levels are common and associated with insulin resistance in men with diabetes. J Clin Endocrinol Metabol. 2008;93:1834-40.

Ali ST, Shaikh RN, Ashfaqsiddiqi N, Siddiqi PQ. Serum and Urinary levels of pituitary: Gonadal hormones in insulin-dependent and non-insulin-dependent diabetic males with and without neuropathy. Arch Androl. 1998;30:117-23.

Al Hayek AA, Khader YS, Jafal S, Khawaja N, Robert AA, Ajlouni K. Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross sectional study. J Family Community Med. 2013;20(3):179-86.

Tsai EC, Matsumoto AM, Fujimoto WY, Boyko EJ. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes Care. 2004 Apr 1;27(4):861-8.

El Baba K, Azar ST. Low testosterone and diabetes. Curr Diabetes Rev. 2013;9(5):418-21.

Fernández-Miró M, Chillarón JJ, Pedro-Botet J. Testosterone deficiency, metabolic syndrome and diabetes mellitus. Med Clin (BARC). 2016;146(2):69-73.

Kalyani RR, Dobs AS. Androgen deficiency, diabetes and the metabolic syndrome in men. Curr Opin Endocrinol Diabetes Obes. 2007:226-34.

Haffner SM, Miettinen H, Karhapää P, Mykkänen L, Laakso M. Leptin concentrations, sex hormones and cortisol in non- diabetic men. J Clin Endocrinol Metab. 1997;82:1807-9.

Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006;166:1660-5.

Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23:490-4.

Oh JY, Barrett-Connor E, Wedick NM, Wingard DL. Endogenous sex hormones and the development of type 2 diabetes in older men and women; the Rancho Bernardo study. Diabetes Care. 2002;25:55-60.

Rhoden EL, Ribeiro EP, Teloken C, Souto CAV. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. Brit J Urology Inter. 2005;96:867-70.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA. Diagnosis and management of the metabolic syndrome an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112:2735-52.

Haffner SM, Shaten J, Stem MP, Smith GD, Kuller L and MRFIT Research Group. Low levels of sex hormone-binding globulin and testosterone predict the development of non-insulin-dependent diabetes mellitus in men. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Ame J Epidemiol. 1996;143:889-97.

Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. J Am Medical Association. 2006;295:1288-99.

Corona G, Mannucci E, Petrone L, Ricca V, Balercia G, Mansani R, et al. Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic. Int J Impot Res Rev. 2006;18:190-7.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl. 1):S81-S90.

International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-34.

Luetjens CM, Weinbauer GF. Testosteron: biosynthesis, transport, metabolism and (non-genomic) actions. In: Nieschlag E, Behre HM, Nieschlag S. Testosterone: Action, Deficiency, Substitution 4th Ed. Cambridge: Cambridge University Press; 2012:15-32.

Swerdloff RS, Wang C, Bhasin S. Developments in the control of testicular function. Baillière's Clin Endocrinol Metabol. 1992;6(2):451-83.

Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. baltimore longitudinal study of aging. longitudinal effects of aging on serum total and free testosterone levels in healthy men. J Clin Endocrinol Metab. 2001;86(2):724-31.

Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab. 2002;87(2):589-98.

Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG, et al. Androgens and diabetes in men. Diabetes Care. 2007;30:234-8.

Kupelian V, ST Page, AB Araujo, Travison TG, Bremner WJ, McKinlay JB. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in non-obese men. J Clin Endocrinol Metabol. 2006;91:843-50.

Yeap BB, Alfonso H, Chubb SA, Handelsman DJ, Hankey GJ, Norman PE and Flicker LA. Reference ranges and determinants of testosterone, dihydrotestosterone, and estradiol levels measured using liquid chromatography-tandem mass spectrometry in a population-based cohort of older men. J Clin Endocrinol Metabol. 2012;97:4030-9.

Corona G, Monami M, Rastrelli G, Aversa A, Sforza A, Lenzi A, et al. Type 2 diabetes mellitus and testosterone: a meta-analysis study. Int J Androl. 2011 Dec;34(6pt1):528-40.

Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes. Diabetes Care. 2007;30:911-7.

Bajaj S, Varma A, Tiwari A. Serum testosterone in males with newly diagnosed type 2 diabetes mellitus and microvascular complications. Sri Lanka J Diabet Endocrinol Metabol. 2016;6:18-22.

Chaudhri S, Kaushik M, Jaswal VMS, Raina R, Thakur R, Thakur MK, et al. Serum testosterone in males with newly diagnosed type 2 diabetes mellitus and microvascular complications. Inter J Res Med Sci. 2018;6:2313-7.

Trivedi J, Kapoor S. A study of serum total testosterone levels in type 2 diabetes mellitus male patients. Annals Inter Med Dental Res. 2017;3:1-5.

Agbecha A, Usoro CA. Serum testosterone and insulin resistance in type 2 male diabetics attending University of Calabar teaching hospital, Nigeria. J Med Soc. 2017;31:178-84.

Khosa Z, Mehboob M, Zubair M. Serum testosterone level in type 2 diabetes mellitus males: a review in urban population of Pakistan. Euro J Biomed Pharma Sci. 2019;6:1-4.