ABSTRACT
Background: A high incidence of hypogonadism in men with Type 2 Diabetes Mellitus has been globally reported. The present study was aimed at determining the frequency of hypogonadism in T2DM males. Screening and management of hypogonadism in Diabetic males should be done.Methods: In this case control study conducted from January 2018 to August 2019 at SGRDIMSR Sri Amritsar 100 Type 2 Diabetic males were taken as cases. 50 age matched nondiabetic males were taken as controls. Apart from BMI and waist hip ratio routine investigations, HbA1C, serum total and free testosterone levels were done. All the subjects were subjected to ADAM questionnaire to evaluate for hypogonadism.Results: Majority of subjects were in the age of 40-50 years. Mean Serum Total Testosterone levels in Study and Control Groups were 4.94�32 nmol/L and 6.63�54 nmol/L respectively (p=0.045). Mean Serum Free Testosterone levels in Study and Control Groups were 4.12�43 pg/ml and 6.05�24 pg/ml respectively (p=0.001). A statistically highly significant negative correlation was found between BMI and Serum Testosterone levels in both groups. Prevalence of hypogonadism (Total Testosterone <4.56 nmol/L) in Study and Control Groups was 73% and 58% respectively. Sensitivity and specificity of ADAM questionnaire was found to be 78.46% and 94.29 % respectively.Conclusions: Prevalence of hypogonadism among T2DM males is high. So, screening for hypogonadism should be done. ADAM questionnaire can be used as a screening tool, results must be confirmed with Serum Total Testosterone levels.
ABSTRACT
Background: Magnesium (Mg) is the fourth most abundant cation in the human body and plays a key role in many fundamental biological processes including metabolism and DNA synthesis. Hypomagnesaemia has also been associated with poor glycemic control and albuminuria in patients with type 2 diabetes mellitus.Methods: The present study was undertaken in the Department of Medicine in SGRDIMSAR, Amritsar on 100 patients diagnosed with type 2 Diabetes Mellitus as per the latest ADA criteria. The patients were divided into 2 groups. Group A with 50 patients with type 2 diabetes mellitus with urinary albumin level >30 mg/dl (Study Group). Group B with 50 patients with type 2 diabetes mellitus with urine albumin levels <30 mg/dl (Control Group).Results: Hypomagnesemia was present in 16 patients i.e. 32% in study group and 12 patients i.e. 24% in control group (P=0.034). In study group with hypomagnesemia, 13 patients i.e. 81.25% and in control group with hypomagnesemia, 4 patients i.e. 33.33% have poor glycaemic control (P=0.033). In study group with hypomagnesemia, 14 patients i.e. 87.5% and in control group with hypomagnesemia, 5 patients i.e. 41.67% were found to have diabetic retinopathy (P=0.010).Conclusions: Hypomagnesemia was directly correlated with hypertension (P=0.004), poor glycaemic control (P=0.033), diabetic retinopathy (P=0.010) and diabetic nephropathy (P=0.034). Hypomagnesemia leads to early microvascular complications as compared to macrovascular complications. Thus, screening of serum magnesium levels in T2DM with albuminuria should alert us to look for hypertension, poor glycaemic control and retinopathy.