Diabetes mellitus (DM), associated with very subtle disorders, affects, either directly or indirectly, various functions of the reproductive system. Adequate, regular, and timely therapy may prevent or delay these disorders. The T synthesis disorder is caused by molecular changes at the level of Leydig cells and may lead to other disorders in all target organs and tissues. The close correlation between Leydig and Sertoli cells function, i.e., between spermatogenesis and second sex glands function, results in certain anomalies in diabetic patients' spermiograms. Parallel lesions associated with DM, through CNS (hypothalamus-hypophysis), and endocrine profile are indirectly intensified or induced by these disorders, which reflect dysfunction of homeostatic balance in carbohydrate metabolism. Sexual dysfunction in all its forms (reduced erection, impotence, and other libido dissociations) is an accompanying phenomenon of the diabetic disease. However, manifestations of these disorders are related to the regulation of carbohydrate metabolism and to the duration of disease. The duration of disease is not necessarily correlated with sexual dysfunction. Even carbohydrate metabolism remains within normal range in addition to other lesions, diabetes leads gradually but progressively to premature aging of body cells.
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