The testosterone levels of people with type 2 diabetes are lower than those of healthy young males. The hypothalamic-pituitary-gonad axis may fail in just a fraction of these individuals, resulting in typical hypogonadism. The cutoff threshold for blood testosterone in males without apparent hypothalamic-pituitary-gonadal axis disease is only a contested matter. Physical syndrome, hyperglycemia, and an increased risk of cardiovascular disease may be caused by both intrinsic and extrinsic factors interacting with the hypothalamic-pituitary-gonadal axis as well as glucose resistance and low-grade inflammation. There is still a need for additional studies to understand whether low blood testosterone levels are directly responsible for the development of unfavorable clinical outcomes, or whether they act as a mediating or moderating factor. At this time, there is no reliable information from randomized clinical studies on the effects of testosterone replacement therapy on significant clinical outcomes. Type 2 diabetics, for example, may have a higher risk of side effects from testosterone treatment than the general population. Low blood testosterone levels in individuals with type 2 diabetes have been linked to increased cardiovascular risk factors, metabolic syndrome, as well as worsening clinical outcomes.

Keywords:  Type 2 diabetes, Low Testosterone, Hypothalamic-pituitary-gonad axis, Glucose intolerance, Metabolic syndrome, Clinical studies.