Diabetes mellitus-induced disruptions of male reproductive functions: A comprehensive review

Diabetes mellitus has emerged as a widespread global health concern, contributing significantly to morbidity and mortality rates. The metabolic disturbances associated with diabetes can adversely impact the male reproductive system, leading to reduced fertility. This review offers an in-depth evaluation of recent global research exploring the impact of diabetes on male reproductive health. Relevant experimental and clinical studies were identified, with a focus on diabetes-related effects on reproductive organs, hormones, and sexual function. The review highlights that insulin deficiency and resistance in diabetic conditions disrupt the hypothalamic-pituitary-gonadal axis, reducing levels of key reproductive hormones such as gonadotropin releasing hormone, luteinizing hormone, follicle stimulating hormone, and testosterone. These hormonal disruptions lead to structural and functional damage in reproductive organs including the testes, Sertoli cells, epididymis, sperm, and accessory glands. Moreover, diabetes contributes to erectile and ejaculatory dysfunctions. Various pathophysiological mechanisms such as oxidative stress, hormonal imbalances, germ cell apoptosis, autophagy, mitochondrial dysfunction, and endoplasmic reticulum stress are identified as underlying contributors to diabetes-induced male infertility. The findings of this review provide valuable insights into the complex mechanisms by which diabetes affects the male reproductive function. By integrating current research, it highlights the critical need for further studies and the development of targeted therapies to effectively address diabetes-induced infertility.