RESUMO
The influence of long term diabetes [5-10 years] on the hypothalamic pituitary gonadal axis was studied in 40 adult [113DM] patients [20 males and 20females] and 30 healthy volunteers [20 male and 10 female] as a control. Plasma level of LH, FSH, and [testosterone and prolactin. in male and progesterone in female] were measured in both diabetic and control subjects. They were also measured in diabetic patients after oral administration of clomiphene citrate in a dose 50 mg /day for 10 days. Results revealed the following. The base line plasma LH and FSH in diabetic patients showed different data in males and in females. In males. there were significant increase in the level of LH, FSH and prolactin compared to the control group. This increase was correlated with a significant decrease in. the level of testosterone, concluding that diabetes Mellitus has a degenerative changes on. the tests .decreasing the testosterone level and consequently by the negative feed back mechanism the level of LH and FSH was increased In females, the base line level of LH, FSH, and progesterone were significantly decreased which may be due to the effect of diabetes on the [HPGA]. On the other hand, after treatment with clomiphine citrate in males, there was significant increase in LH, FSH but with no change in testosterone level. These data added further support to our conclusion that the effect of diabetes is mainly at the testicular level more than central since the treatment increased the negative feed back mechanism leading to further increase in LH level. The data in the female patients after treatment showed significant increase in plasma t LH, FSH, and progesterone. But concerning the increase in progesterone level it can not reach the control level, concluding that the [IDDM] affect the female reproductive function both centrally at the level of [HPGA] and locally at the level of the gonads. As a result of these data, clomiphen citrate can be used in female patients but it is considered of limited value in male diabetic patients