Background: Testosterone levels are commonly lowered in men with diabetes but it is unclear whether these impact upon symptoms of androgen deficiency and diabetes-related quality of life.
Objective: To investigate the relationship between testosterone levels, symptoms of androgen deficiency, erectile function and diabetes-related quality of life in men with type 1 and type 2 diabetes. Design: Cross-sectional study of 115 men with type 2 diabetes, 93 men with type 1 diabetes and 121 healthy controls.
Results: Forty-five and sixty-one percent of men with type 2 diabetes had low total and calculated free testosterone levels, respectively. Total testosterone levels were not lowered in men with type 1 diabetes but 32% had low calculated free testosterone. After adjustment for age and waist circumference, only calculated free testosterone in men with type 2 diabetes (−0.037 nmol/l, 95% CI −0.075 to −0.0003, P=0.048) remained lowered compared with controls. Calculated free testosterone correlated weakly with Androgen Deficiency in the Aging Male (r=−0.26, 95% CI −0.42 to −0.08, P=0.006), International Index of Erectile Function (r= 0.19, 95% CI 0.01 to 0.37, P=0.042) and Audit of Diabetes Dependent Quality of Life (r= 0.21, 95% CI 0.03 to 0.38, P=0.022) scores in men with type 2, but not type 1 diabetes. Age exerted the predominant effect on erectile function in both groups, in a model incorporating age, testosterone level and complications.
Conclusions: Testosterone levels are strongly affected by age and central obesity in men with type 1 and type 2 diabetes but correlate weakly with symptoms of androgen deficiency and erectile function. Testosterone levels do not appear to be a major determinant of quality of life in patients with diabetes.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.