Diabetic Men Research Articles

Association between Diabetes Mellitus and Benign Prostatic Hyperplasia

Background: Previous studies had documented a causal relationship between diabetes mellitus (DM) and benign prostatic hyperplasia (BPH) through hyperinsulinaemia and increased serum levels of insulin-like growth factor-1 (IGF-1). These growth factors contribute to prostatic enlargement and may cause lower urinary tract symptoms (LUTS) and increase symptom severity in BPH patients. This study was aimed at associating DM with clinical parameters of BPH. Materials and Method: This was a retrospective study of one hundred and sixteen (116) BPH patients carried out over a year period. Their clinical, laboratory and imaging study results were retrieved from their case files. Eligible patients were taken through a structured questionnaire during their clinic visits. This questionnaire assesses severity of LUTS in BPH patients called the International Prostate Symptom Score (IPSS) and quality of life scale. All data were entered into a structured proforma and analyzed using the statistical package for social sciences (SPSS) version 20.0 software. Diabetic patients were selected based on the clinical history of diabetes mellitus (DM). Results: One hundred and Sixteen (116) patients aged between 43 and 82 years with a mean age of 63.10±8.89 years were studied. Diabetic patients were older than non-diabetics. They also had higher clinical parameters of BPH namely; higher prostate volume (PV), higher symptom scores both voiding and storage and a poorer quality of life from symptom-bother. Conclusion: Diabetic men have higher prostate volume which can precipitate LUTS, cause BPH progression and symptom severity.

Correlation between reproductive hormones levels and semen quality in patients with diabetes

Diabetes mellitus (DM) is rarely sought among infertile patients due to a lack of studies and inconsistency regarding its impact on semen quality. This cross-sectional study aimed to determine the influence of T2DM on the pituitary gland hormones (FSH and LH) in males. A total of 60 participants participated in this study, of which 35 were diagnosed with diabetes mellitus, and 25 were without diabetes. Fasting blood sugar, HbA1c, LH, FSH, TT, E2, and prolactin were tested. Diabetic men had lower serum LH, FSH, and TT levels than non-diabetics and higher prolactin and E2 levels. According to the semen examination, including sperm count, PH, motility, and morphology, diabetic patients had considerably lower sperm counts, motility, and morphology than non-diabetic patients. In conclusion, the decrease in the concentration of reproductive hormones in diabetic patients leads to sexual weakness, resulting in abnormal seminal fluid parameters, which are below the normal levels than in apparently healthy persons.

PROSTATE CANCER AND DIABETES: BIOLOGY OR DETECTION BIAS?

Prostate cancer and diabetes are the two highly prevalent health problems in men worldwide and have a high mortality rates but their association is quite complex and contradictory. This review reported several population based studies which tried to establish a possible association and explains the mechanism by which diabetes exhibits its effect on prostate cancer progression. It also explores the literature around the expression of various receptors and genes which enlightens the possible molecular basis of association and the effect of current antidiabetic drugs like metformin and insulin on the growth and advancement of prostate cancer in diabetic men. Masking of early tumor detection by diabetes might be the possible explanation for the reported inverse association with worse prognosis and shorter survival rate in diabetic prostate cancer patients.

Recognizing the True Value of Testosterone Therapy in Health Care.

There has been little recognition within the medical community of the health impact of testosterone (T) deficiency (TD), also known as hypogonadism, and the substantial benefits of testosterone therapy (TTh) on health and quality of life despite high-level clinical evidence. In a roundtable symposium, investigators summarized the contemporary evidence in several key clinical areas. TD negatively impacts human health and quality of life and is associated with increased mortality. Several studies have demonstrated that TTh in men with TD reduced all-cause and cardiovascular mortality. The longstanding belief that TTh is associated with increased prostate cancer (PCa) risk is contradicted by recent evidence, including multiple studies showing that TTh is associated with reduced PCa risk. Similarly, the weight of current evidence indicates the purported concern that TTh is associated with increased cardiovascular risk is incorrect. Normalization of physiological T reduces myocardial infarction, stroke, and deaths compared with men whose testosterone levels failed to normalize. In diabetic men TTh improves insulin resistance, and a large 2-year controlled study in men with abnormal glucose tolerance showed a substantially reduced rate of diabetes among men treated with TTh compared with untreated controls. Long-term TTh in diabetic men resulted in progressive improvements in obesity and insulin requirements, including a substantial number who experienced complete remission of diabetes. Finally, TTh has been shown to reduce severe outcomes with Covid-19 infection. These lines of evidence argue strongly for the need for greater awareness in the medical community of the impact of TD on health, and of the health benefits of TTh.

Burden of noncommunicable diseases in Pakistan.

Cases of noncommunicable (NCD) diseases are increasing in Pakistan. They are responsible for 58% of all deaths and information on the risk factors is lacking. To determine the prevalence of diabetes, hypertension and abnormal heart rate and their risk factors in a multiethnic, low-income area of Lahore. This was a cross-sectional study conducted in an urban settlement of Lahore in 2018-2019. Eligible participants were aged ≥ 30 years and resident in selected settlements. We used a modified World Health Organization stepwise approach to NCD risk factor surveillance (STEPS) questionnaire to collect data from a random sample of 906 residents. The modified questionnaire had a Cronbach alpha of 80.0%. Participants were interviewed in their homes and their height, weight, heart rate, and hip circumference were measured. Most of the respondents were women (64.5%). The greatest proportion of the participants were aged 30-39 years (42.4%). Of all the respondents, 40.1% had hypertension, 15.8% had diabetes and 17.0% had ischaemic heart disease. Of the risk factors examined, 68.8% of the respondents were overweight or obese, 37.0% had pre-hypertension, 13.6% used tobacco, and 1.8% used alcohol. Age was the most significant risk factor for noncommunicable diseases. Body mass index was significantly associated with diabetes in women, while family history of diabetes was significantly associated with diabetes in men. The prevalence of hypertension and diabetes was higher among our study participants in Lahore than reported in the national statistics. Significant proportions of the respondents had pre-hypertension and pre-diabetes, making them vulnerable to serious complications of hypertension and diabetes.

IBC-Ox34 Transit bipartition improves serum total testosterone levels in overweight and obese type-2 diabetic men and cures erectile dysfunction: short-term preliminary results

Abstract Introduction In males, erectile dysfunction (ED) secondary to obesity is one of the most common cause of male sexual dysfunction, in our study we investigated the effect of bariatric surgery on male sex hormone, testosterone and sexual status of 99 overweight and obese men with type II diabetes who underwent a laparoscopic transit bipartition. Methods Ninety-nine patients with type-II diabetes mellitus (T2DM) and obesity who underwent transit bipartition in Hospital X were prospectively evaluated before and 6 months after the surgery for the serum total testosterone levels. Also, the erectile dysfunction was evaluated by using International Index of Erectile Function (IIEF) scoring system. In addition, all the patients had been evaluated in BMI categories of overweight (BMI 25-29), Class 1 Obese (30-35), Class 2 Obese (35-40) and morbidly obese (>40 kg/m2). Results Serum total testosterone (T) levels were assessed before and 6 months after TB in 99 male patients. Mean age was 45.7 and median serum total testosterone (T) levels before and after 6 months were 3.03 nmol/L (range: 0.38-8.44) and, 4.43 nmol/L (range 0.34-9.70) (min-max) respectively. Also, the patient's pre-operative and post-operative testosterone values and IIEF scores were calculated in every category of obesity (Table 1). Before and after bariatric surgery serum T levels were statistically significant (p<0.005). Conclusion In conclusion serum T levels and IIEF scores significantly improved after 6 months following bariatric surgery. This condition may explain improvement of erectile dysfunction following bariatric surgery. Larger and long-term studies are required to investigate these beneficial effects of surgery in patients with obesity and T2DM.

Impotence and Lack of Sexual Desire, Their Relation to Patients With Diabetes

The main objective of this study was to investigate the prevalence of sexual disorders in diabetics, owing to diabetes constitutes a growing public health problem, leading to a variety of dysfunctions such as cardiovascular, psychological, and sexual dysfunctions, that is why Diabetes is a well-known cause of sexual disorders, with prevalence rates approaching 50% in both type 1 and type 2 diabetes, but the determinants of sex dysfunction in diabetic men as a result of the principal cardiovascular risk factors, such as hypertension, and also overweight obesity, in addition to metabolic syndrome, smoking, and sedentary lifestyles. Moreover, sexual disorders considered as important predictors of the development of major complaints in diabetic patients, on the other hand, the debate as to whether diabetes link with sexual dysfunction or not, is an issue of controversy, moreover, diabetic women suffer from the same neurovascular complications that contribute to the pathogenesis of SD in men, however, results of sexual functioning of diabetic women are less conclusive. Conclusion: extending beyond the specific effects on sexual dysfunction in men and women with diabetes, the adoption of these measures promotes a healthier life and increased well-being, which in turn, may help to reduce the burden of sexual dysfunction.

Relationship between serum testosterone and sex hormone- binding globulin levels and some metabolic changes in Iraqi men with type 2 diabetes mellitus

The present study aimed to assess the interrelationship between serum total testosterone (S.Tes) as well as sex hormone binding globulin (SHBG) and the main components of metabolic syndrome (MetS) in type 2 diabetic men. One hundred and sixty patients having T2DM were enrolled in this study. The following characteristics were reported: age, gender, duration of T2DM , Body mass index (BMI) and arterial blood pressure.. Serum hormonal profile analyses (S.Tes, SHBG and prolactin). Serum lipid analyses (T.ch TG, HDL-C, and LDL-C). The mean age of study subjects was 49.8 5.7 years and the mean duration of disease was 5.45.2 years. Body mass index (BMI) of study group was found to be within the range of either overweight or obese class . The means of HbA1c ratio and FSG levels were 9.4 %  2.1 and 200.9  75.2 mg/dl respectively which indicated that our patients were in a bad glycemic control. All components of S. lipid profile were within normal range . Serum Testosterone and SHBG levels were within normal range but in the low values( 4.49±2.11 ,28.88±18.12 ng/ml respectively) while serum prolactin level was within normal range but in the high values (11.22±9.42 ng/ml). When study analytes were compared according to the presence of one or more metabolic syndrome characteristic then there was a significant decrease in mean value of testosterone level between obese and non obese diabetics ( 3.89±1.87 vs. 4.79±2.17 ng/ ml, P < 0.001) . If hypertension was present in addition to obesity and diabetes then SHBG level was also significantly decreased in comparison with diabetics who were hypertensive but not obese (25.16±13.42 vs. 33.58±13.73 ng/ ml respectively , P <0.05 ). If hypertension and obesity were present as well as lower HDL-C then significant decreases in both S. SHBG and S. Tes were detected ( (30.63±14.93 vs. 40.7± 6.33 ng/ ml and 3.73±1.9 vs. 5.57±1.53 ng/ ml respectively , P<0.01). In conclusion; our T2DM patients have a bad glycemic state and are characterized by a significantly lower S. Tes mean level if they were obese. Still, the accumulation of other main characteristics of MetS which included hypertension and lower S. HDL- C results in a significantly lower mean levels of both S. Tes and S. SHBG. Obesity, among the other core characteristics of MetS, seems to have the main suppressor effect on serum testosterone and SHBG in T2DM.

Abstract #1324368: Incidence and Risk Factors of Low Testosterone Levels in Diabetic and Nondiabetic Men

To determine the prevalence of subnormal testosterone concentrations (hypogonadism) based on both symptoms and biochemical available measures in patients with type 2 diabetes and healthy men and determine its associated factors.

"I Could Have Stood a Little More Education Rather than Just: 'Hey, you're Diabetic Man, Make the Best out of It'": Revisioning Diabetes Self-Management Education for Older Adults.

Objectives: Providing diabetes self-management education (DSME) in an evidence-based format that is accessible and tailored to the population needs is crucial for individuals living with diabetes mellitus. Our qualitative study explores the experiences of older adults living with diabetes while residing in a rural setting. Methods: Adults aged 65 or older and residing in a rural area of Ontario completed a photovoice activity and semi-structured interviews to illustrate their experience of living with diabetes and accessing DSME. Results: Fourteen participants (11 males; mean age = 74 years) completed the photovoice activity and interview. Four main themes were identified pertaining to learning about diabetes education, the depth and breadth of learning, applying knowledge to daily life, and engaging older adults in DSME. Discussion: Diabetes self-management education should account for older adults' preferences in learning about diabetes and self-management to promote access to evidence-based information, bolster knowledge and self-management efficacy, and improve disease control.

BMI variability and incident diabetes mellitus, Tehran Lipid and Glucose Study (TLGS)

Previous epidemiologic studies debated the association of body mass index (BMI) trends with cardiovascular disease and mortality. This study aimed to evaluate the association of BMI variability and slope with the incidence of Type 2 diabetes mellitus (T2DM) in a sex-stratified 15.8-year follow-up in the population-based Tehran Lipid and Glucose Study (TLGS). Of 10,911 individuals aged 20–60 years, 4981 subjects were included and followed for 15.8-years. The slope coefficient of BMI in the linear regression model represented individuals’ BMI trends up to the incidence of DM. The root mean squared error (RMSE) of the BMI linear trend was selected to reflect BMI variability through six follow-ups. Cox proportional hazards regression was used to investigate the association of the baseline BMI, BMI slope and RMSE with the incidence of T2DM among men and women. Multivariable-adjusted HRs of T2DM for each SD increment in BMI slope was 1.18 (95% CI: 0.94–1.48, p = 0.161) in normal weight men and 1.26 (95% CI: 1.10–1.44, p = 0.001) in overweight and obese men. However, in women, each SD increment in BMI slope increased the risk of T2DM with a HR of 1.19 (95% CI: 1.01–1.40, p = 0.039) in normal weight, and 1.14 (95% CI: 1.08–1.19, p < 0.001) in women with BMI ≥ 25 kg/m2. In men with a baseline BMI ≥ 25 kg/m2, BMI-RMSE was associated with a decreased risk of T2DM (HR: 0.71, 95% CI: 0.53–0.93, p = 0.015). Baseline BMI was not associated with the risk of diabetes in men and women. Positive BMI slope is associated with the development of diabetes in both sexes. The association of BMI variability with incident T2DM differs according to sex and baseline BMI. BMI variability is associated with a lower risk of T2DM in overweight and obese men. BMI variability in women and baseline BMI in both gender are not related to the risk of T2DM.

Inhibition of sodium-glucose cotransporter 2 suppresses renal stone formation

Background and aimsNephrolithiasis is a common renal disease with no effective medication. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, an anti-diabetic agent, have diuretic and anti-inflammatory properties and could prevent nephrolithiasis. Here, we investigated the potential of SGLT2 inhibition against nephrolithiasis using large-scale epidemiological data, animal models, and cell culture experiments. MethodsThis study included the data of diabetic patients (n = 1,538,198) available in the Japanese administrative database and divided them according to SGLT2 inhibitor prescription status. For animal experiments, renal calcium oxalate stones were induced by ethylene glycol in Sprague-Dawley rats, and phlorizin, an SGLT1/2 inhibitor, was used for the treatment. The effects of SGLT2-specific inhibition for renal stone formation were assessed in SGLT2-deficient mice and a human proximal tubular cell line, HK-2. ResultsNephrolithiasis prevalence in diabetic men was significantly lower in the SGLT2 inhibitor prescription group than in the non-SGLT2 inhibitor prescription group. Phlorizin attenuated renal stone formation and downregulated the kidney injury molecule 1 (Kim1) and osteopontin (Opn) expression in rats, with unchanged water intake and urine volume. It suppressed inflammation and macrophage marker expression, suggesting the role of the SGLT2 inhibitor in reducing inflammation. SGLT2-deficient mice were resistant to glyoxylic acid-induced calcium oxalate stone formation with reduced Opn expression and renal damages. High glucose-induced upregulation of OPN and CD44 and cell surface adhesion of calcium oxalate reduced upon SGLT2-silencing in HK-2 cells. ConclusionOverall, our findings identified that SGLT2 inhibition prevents renal stone formation and may be a promising therapeutic approach against nephrolithiasis.

Inflammaging and body composition: New insights in diabetic and hypertensive elderly men

Age-related changes in the body's physiological responses play a critical role in systemic arterial hypertension (SAH) and type 2 Diabetes mellitus (T2DM). SAH and T2DM have clinically silent low-grade inflammation as a common risk factor. This inflammation has a relevant element, the excess of fatty tissue. In this scenario, little is known about how inflammatory markers interact with each other. Therefore, this work evaluated the interplay among anthropometric, biochemical, and inflammatory markers in the elderly with SAH and T2DM. Men aged 60–80 years old with SAH and T2DM were classified by body mass index (BMI) as eutrophic elderly (EE, 24 individuals) or overweight elderly (OE, 25 individuals). Body composition analysis was performed using bioimpedance. Blood samples were collected to perform inflammatory and biochemical evaluations. The cytokines IL-17A, IL-1β, IFN-y, TNF-α, and IL-10, were evaluated by ELISA. Triglycerides, total and fractions of cholesterol, and glucose were measured by spectrophotometry. Overweight elderly men had a higher glycemic index and an increase in most anthropometric markers, as well as higher means for all pro-inflammatory cytokines analyzed (IL-17A, IL-1β, IFN-y, and TNF-α) in comparison to their eutrophic elderly counterparts. However, there was a decrease in IL-10 anti-inflammatory cytokine and IL-10/IL-17A ratio compared to their eutrophic elderly counterparts. Although overweight elderly men have worsening inflammatory parameters, the magnitude of their correlations with anthropometric and biochemical parameters becomes less evident. The Bayesian networks highlight that in the eutrophic elderly, IL-17A and TNF-α are the cytokines most associated with interactions, and most of these interactions occur with biochemical parameters. It is worth highlighting the role of IFN-y in overweight elderly men. This cytokine influences IL-10 and TNF-α production, contributing to the inflammatory profile exacerbated in this group.

Association of erectile dysfunction with diabetic foot and its outcomes in type 2 diabetic men.

Erectile dysfunction (ED) and diabetic foot (DF) are common complications in patients with diabetes. However, the relationship between ED and DF has been little studied. In particular, no study has evaluated whether ED is associated with the outcomes of DF. The aim of this retrospective cohort study was to investigate whether ED is a predictor of the outcomes of DF in a large population of men with DF. Three hundred and twenty-six consecutive men with type 2 diabetes and a recent and single DF ulcer were recruited and followed up for 41.7 ± 22.7months. Among men with DF, 56.1% had ED (ED group) and 43.9% did not (NO ED group). Wound healing rate was significantly higher in the NO ED than in the ED group (90.2 versus 73.3%; p = 0.0001). Minor amputation rate (13.7 versus 4.8%; p = 0.007) and mortality (25.7 versus 0.7%; p < 0.001) were significantly greater in the ED than in the NO ED group. Among 263 patients with healed ulcers, recurrence rate was significantly higher in the ED than in the NO ED group (51.5 versus 26.3%; p < 0.001). Multivariate analysis showed that the absence of ED was associated with wound healing (OR: 0.459; 95% CI: 0.213-0.993; p = 0.048), while the presence of ED predicted mortality (OR: 22.644; 95% CI: 2.976-34.271; p = 0.002) and DF recurrence (OR: 3.498; 95% CI: 1.882-6.499; p < 0.001). Our data show that among men with DF the prevalence of ED is very high. Moreover, ED may be a strong predictor of wound healing, mortality, and ulcer recurrence.

Cytochrome P450 3A4-mediated pharmacokinetic interaction study between tadalafil and canagliflozin using high-performance thin-layer chromatography.

Diabetes is a known risk factor for sexual dysfunction in men; diabetic men have an increased risk of erectile dysfunction compared to non-diabetic men. Canagliflozin is one of the common antidiabetic drugs that is readily used in the treatment of type-2 diabetes. Concomitantly phosphodiesterase 5 inhibitors, such as tadalafil, can be given to the patient to alleviate erectile dysfunction. Canagliflozin is reported to be one of the cytochrome P450 3A4 enzyme inhibitors, that might seriously influence blood concentration levels of tadalafil but there is no study till now, discussing this interaction. Therefore, a fast, simple, and sensitive high-performance thin-layer chromatographic method was developed, validated, and applied for the simultaneous determination of tadalafil and canagliflozin in spiked and real human plasma. The limit of detection for tadalafil was 0.14ng/band and for canagliflozin was 0.16ng/band. The limit of quantitation value for tadalafil was 0.43ng/band and for canagliflozin was 0.47ng/band. Tadalafil and canagliflozin were determined simultaneously in real human plasma using the described procedure and the method was applied for in vivo pharmacokinetic drug interaction study between the studied drugs, which proved significant interaction between them when administered simultaneously.

Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study.

Evidence regarding the impact of education on diabetes risk is scarce in developing countries. We aimed to explore the association between education and diabetes within a large population in China and to identify the possible mediators between them. Information on educational level and lifestyle factors was collected through questionnaires. Diabetes was diagnosed from self-report and biochemical measurements. A structural equation model was constructed to quantify the mediation effect of each mediator. Compared with their least educated counterparts, men with college education had a higher risk of diabetes (odds ratio [OR] 1.19; 95% confidence interval [CI], 1.12-1.27), while college-educated women were less likely to have diabetes (OR 0.77; 95% CI, 0.73-0.82). Obesity was the strongest mediator in both genders (proportion of mediation: 11.6% in men and 23.9% in women), and its association with education was positive in men (β[SE] 0.0387 [0.0037]) and negative in women (β[SE] -0.0824 [0.0030]). Taken together, all behavioral factors explained 12.4% of the excess risk of diabetes in men and 33.3% in women. In a general Chinese population, the association between education level and diabetes was positive in men but negative in women. Obesity was the major mediator underlying the education disparities of diabetes risk, with a stronger mediation effect among women.

Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population.

ObjectiveThis study investigated the association between relative hand grip strength (HGS) and glycemic status, such as impaired fasting glucose (IFG) and diabetes, using data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsWe performed a cross-sectional study using the data from the KNHANES of 27,894 individuals from 2014 to 2019. Relative HGS was defined as the absolute HGS divided by body mass index and divided into quartiles in men and women. Odds ratios (OR) for diabetes and IFG were calculated using multivariate logistic regression analysis. All analyses were stratified by sex, and subgroup analysis was age-stratified.ResultsThe lowest relative HGS quartile had a significant increase in the risk for diabetes (men: OR 2.72, 95% confidence interval [CI] 2.12–3.50; women: OR 3.38, 95% CI 2.70–4.24) and IFG (men: OR 1.35, 95% CI 1.15–1.59; women: OR 1.60, 95% CI 1.40–1.84). The ORs for diabetes and IFG according to the decreasing quartiles of relative HGS gradually increased in both sexes (P for trend <0.001). ORs and 95% CI of the lowest relative HGS quartile for diabetes were higher in the younger age group than that of the older age group (men: 4.47 and 2.80–7.14 for young adults; 2.41 and 1.37–4.25 for older adults; women: 5.91 and 3.06–9.38 for young adults; 1.47 and 0.92–2.33 for older adults). ORs and 95% CI for IFG was similar with the trend of ORs for diabetes (men: 1.80 and 1.43–2.26 for young adults; 1.17 and 0.75–1.84 for older adults; women: 2.20 and 1.77–2.72 for young adults; 1.33 and 0.86–2.07 for older adults).ConclusionLower relative HGS was associated with a higher risk of not only diabetes but also IFG in both sexes. These trends were stronger in younger adults than in older adults.

The Outcome of Daily Low Dose of Tadalafil in Diabetic Men with Erectile Dysfunction

The Outcome of Daily Low Dose of Tadalafil in Diabetic Men with Erectile Dysfunction

All-cause and cardiorenal mortality in 6 million adults with and without type 2 diabetes: A comparative, trend analysis in Canada, Spain, and the UK.

To understand geographical and temporal patterns in the diabetes gap, the excess mortality risk associated with type 2 diabetes (T2D), in three high-income countries. Using databases from Canada (Ontario), Spain (Catalonia) and the UK (England), we harmonized the study design and the analytical strategy to extract information on subjects aged over 35 years with incident T2D between 1998 and 2018 matched to up to five subjects without diabetes. We used Poisson models to estimate age-specific mortality trends by diabetes status and rate ratios and rate differences associated with T2D. In more than 6 million people, 694 454 deaths occurred during a follow-up of 52 million person-years. Trends in all-cause mortality rates differed between Ontario and England; yet, the diabetes gaps were very similar in recent years: in 2018, we estimated 1.3 (95% confidence interval: 0.8, 1.8) and 0.8 (0.2, 1.5) more deaths per 1000 person-years in 50-year-old men with diabetes in Ontario and England, respectively, and 8.9 (6.1, 11.7) and 12.1 (9.1, 15.1) in 80-year-old men; between-country differences were small also in women. In Catalonia, rate ratios comparing T2D with no diabetes in men in 2018 were 1.53 (1.11, 2.11) at 50 years old, 0.88 (0.72, 1.06) at 60 years old, 0.74 (0.60, 0.90) at 70 years old and 0.81 (0.66, 1.00) at 80 years old, indicating lower mortality rates in men with T2D from the age of 60 years; rates were similar in women with and without diabetes at all ages. The diabetes gaps in cardiorenal mortality mirrored those of all-cause mortality: we observed consistent reductions in the proportions of cardiorenal deaths in subjects aged 80 years but variations in subjects aged ≤70 years, regardless of the presence of diabetes. By reducing the confounding impact of epidemiological and analytical differences, this study showed geographical similarities and differences in the diabetes gap: an excess risk of all-cause and cardiorenal mortality in subjects with T2D is still present in Ontario and England in recent years, particularly in elderly subjects. Conversely, there were very small gaps in young men with T2D or even lower mortality rates in older subjects with T2D in Catalonia.

PREVALENCE OF LOW FREE TESTOSTERONE LEVEL IN MEN WITH TYPE 2 DIABETES MELLITUS

Background &#x0D; Prevalence of low serum free testosterone levels in men with type2 diabetes mellitus has been reported worldwide.&#x0D; Objectives &#x0D; To find the prevalence of low free testosterone levels in type2 diabetic men.&#x0D; Patients and Methods&#x0D; 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 &amp;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.&#x0D; Results&#x0D; 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. &#x0D; Conclusion&#x0D; The level of free testosterone in type2 diabetic men was average; there was no correlation between serum HbA1c concentration and serum-free testosterone.