• Taha Othman Mahwi Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Soran Khalil Hassan Iraq Board Candidate of Internal Medicine, Sulaimani, Kurdistan Region, Iraq.



Type2 diabetes mellitus, Serum-free testosterone level



Prevalence of low serum free testosterone levels in men with type2 diabetes mellitus has been reported worldwide.


To find the prevalence of low free testosterone levels in type2 diabetic men.

Patients and Methods

A cross-sectional study was carried out in (the Diabetic and Endocrine Center) in Sulaimani from the 5th of April, 2017, to the 3rd of January, 2018. Eighty-eight male patients of type two diabetes mellitus who attended the centre for regular follow-up are included. After taking consent and history from the patient, a questionnaire was taken on Sociodemographic data and diabetic characteristics (duration &type of treatment), body mass index, and statin use. In addition, blood tests, including; free testosterone, were measured from morning samples using the ELISA kit (bioactive diagnostic, free testosterone ELISA kit), blood sugar (fasting), HbA1c, serum cholesterol, and serum triglyceride were done for all patients.


There was little relation (correlation coefficient =0.07) (p-value 0.49) between free testosterone and HbA1c% concentration, and serum HbA1c% does not seem to contribute significantly to the free testosterone level variation. Duration of diabetes does not affect free testosterone levels. 


The level of free testosterone in type2 diabetic men was average; there was no correlation between serum HbA1c concentration and serum-free testosterone.


Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther. 2008; 88(11):1254–1264. DOI:

Holmboe SA, Jensen TK, Linneberg A, Scheike T, Thuesen BH, Skakkebaek NE, et al. Low Testosterone: A Risk Marker Rather Than a Risk Factor for Type 2 Diabetes. J Clin Endocrinol Metab. 2016; 101(8):3180-90. DOI:

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. DOI:

Kaufman JM, Vermeulen A. The decline of androgen levels in older men and its clinical and therapeutic implications. Endocr Rev. 2005; 26(6):833–76. DOI:

Jones TH. Clinical awareness and diagnosis of male hypogonadism. J Men's Health. 2008; 5(S): S26–34. DOI:

Betancourt-Albrecht M, Cunningham GR. Hypogonadism and diabetes. Int J Impot Res. 2003; 15 Suppl 4: S14-20. DOI:

Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010; 33(6):1186-92. DOI:

Brand JS, Rovers MM, Yeap BB. Testosterone, sex hormone-binding globulin and the metabolic syndrome in men: an individual participant data meta-analysis of observational studies. PLoS One. 2014;9: e100409. DOI:

Dandona P, Dhindsa S, Chaudhuri A, Bhatia V, Topiwala S. Hypogonadotropic hypogonadism in type 2 diabetes. Ageing Male. 2008; 11(3):107-17. DOI:

Bellastella G, Maiorino MI, Olita L, De Bellis A, Giugliano D, Esposito K. Anti-pituitary antibodies and hypogonadotropic hypogonadism in type 2 diabetes: in search of a role: Diabetes Care. 2013 Aug;36(8): e116-7. DOI:

American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Diabetes care. 2017 Jan;40(Suppl 1): S11-S24. DOI:

Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97. DOI:

Grossmann M, Wu FC. Male androgen deficiency: a multisystem syndrome. Asian J Androl. 2014; 16(2):159–160. DOI:

El Saghier EO, Shebl SE, Fawzy OA, Eltayeb IM, Bekhet LM, Gharib A. Androgen Deficiency and Erectile Dysfunction in Patients with Type 2 Diabetes. Clin Med Insights Endocrinol Diabetes. 2015; 8:55-62. DOI:

Ho CH, Jaw FS, Wu CC, Chen KC, Wang CY, Hsieh JT, et al. The prevalence and the risk factors of testosterone deficiency in newly diagnosed and previously known type 2 diabetic men: J Sex Med. 2015; 12(2):389-97. DOI:

Rhoden EL, Ribeiro EP, Teloken C, Souto CA. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. BJU Int. 2005; 96(6):867–70. DOI:

Rezvani MR, Saadatjou SA, Sorouri S, Hassanpour Fard M. Comparison of serum free testosterone, luteinizing hormone and follicle-stimulating hormone levels in diabetics and nondiabetics men- a case-control study. J Res Health Sci. 2012; 12(2):98-100.

Trummer H, Habermann H, Haas J, Pummer K. The impact of cigarette smoking on human semen parameters and hormones. Hum Reprod. 2002; 17(6):1554-9. DOI:

Barbieri RL, Gochberg J, Ryan KJ. Nicotine, cotinine, and anabasine inhibit aromatase in human trophoblast in vitro. J Clin Invest. 1986; 77(6):1727-33. DOI:

Fukui M, Soh J, Tanaka M, Kitagawa Y, Hasegawa G, Yoshikawa T, et al. Low serum testosterone concentration in middle-aged men with type 2 diabetes. Endocr J. 2007; 54(6):871-7. DOI:

Ganesh HK, Vijaya Sarathi HA, George J, Shivane VK, Bandgar T, Menon PS, et al. prevalence of hypogonadism in patients with type 2 diabetes mellitus in an Asian Indian study group: Endocr Pract. 2009; 15(6):513-20. DOI:

Stanworth RD, Kapoor D, Channer KS, Jones TH. Statin Therapy Is Associated with Lower Total but Not Bioavailable or Free Testosterone in Men with Type 2 Diabetes. Diabetes Care. 2009; 32(4): 541–546. DOI:

Deslypere JP, Vermeulen A. Leydig cell function in ordinary men: effect of age, lifestyle, residence, diet, and activity. J Clin Endocrinol Metab. 1984; 59(5): 955–962. DOI:

Dobs AS, Miller S, Neri G, Weiss S, Tate AC, Shapiro DR, Musliner TA. Effects of simvastatin and pravastatin on gonadal function in male hypercholesterolemic patients: Metabolism. 2000 Jan;49(1):115-21. 25 DOI:

Saboor Aftab SA, Kumar S, Barber TM. The role of obesity and type 2 diabetes mellitus in developing male obesity-associated secondary hypogonadism. Clin Endocrinol (Oxf). 2013; 78(3):330-7. DOI:

Tripathy D, Dhindsa S, Garg R, Khaishagi A, Syed T, Dandona P. Hypogonadotropic hypogonadism in erectile dysfunction associated with type 2 diabetes mellitus: a common defect? Metab Syndr Relat Disord. 2003; 1(1):75-80. DOI:

Grossmann M, Thomas MC, Panagiotopoulos S, Sharpe K, Macisaac RJ, Clarke S, et al. Low testosterone levels are commonly associated with insulin resistance in men with diabetes. J Clin Endocrinol Metab. 2008; 93(5):1834-40. DOI:

Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care. 2007; 30(4):911–917. DOI:



How to Cite

Mahwi T, Hassan S. PREVALENCE OF LOW FREE TESTOSTERONE LEVEL IN MEN WITH TYPE 2 DIABETES MELLITUS. JSMC [Internet]. 2022 Sep. 21 [cited 2024 Jul. 22];12(3):289-95. Available from:

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