Aims: To study the effect of testosterone undecanoate on sexual functions, glycaemic parameters, and cardiovascular (CV) risk factors in hypogonadal men with type 2 diabetes mellitus (T2DM). Methods: It was an open label, single-arm interventional study where testosterone undecanoate (TU) was used in 105 T2DM males aged 30–60 years with hypogonadism. The effect of TU on sexual functions was assessed using the Aging Male Symptoms (AMS) Scale and the International Index of Erectile Function-5 (IIEF-5) Questionnaire. The effect on glycaemic parameters, cardiovascular risk factors (lipids, high-sensitivity C-reactive protein [hsCRP] and carotid intima media thickness [CIMT]) were assessed over a period of 54 weeks of TU therapy. Results: Prevalence of hypogonadism in T2DM patients was 19.1%, of which 74.1% had functional hypogonadism. AMS and IIEF-5 scores showed negative and positive correlation, respectively, with baseline serum testosterone levels. The AMS score showed a significant reduction of 5.8% and IIEF-5 score improved by 31.5% at 54 weeks of TU therapy. Glycosylated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and lipids such as total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG) were significantly reduced by 0.6%, 10.9%, 6.28%, 9.04%, and 6.77%, respectively, at 54 weeks. CIMT was significantly reduced by 2.57% at 54 weeks, whereas no significant change observed with hsCRP. Conclusions: TU is an effective treatment modality for hypogonadal men with T2DM, and it has beneficial effects on sexual functions, glycaemic parameters, and CV risk factors.

Aims: The aim of this prospective study was to investigate the role of serum irisin during early pregnancy to predict the development of GDM at 24–28 weeks in high-risk patients. Methodology: This study was conducted among the pregnant women attending the Department of Endocrinology and antenatal clinic of Department of Obstetrics and Gynecology of MKCG Medical College for a period of one year with at least one risk factor for the development of gestational diabetes mellitus (GDM). Blood samples were collected for measurement of fasting plasma glucose, serum insulin, serum irisin, lipids (TC, LDL, HDL, TG), and HbA1c. Oral glucose tolerance test was performed using 75 g of glucose during the first trimester and between 24–28 weeks of pregnancy. Patients were diagnosed as GDM based upon IADPSG criteria at 24–28 weeks. Serum irisin, glycemic parameters, and homeostatic model assessment of insulin resistance during first trimester were analyzed for predicting GDM between 24–28 weeks. Results: Sixty-five patients were included in the study, out of which 20 (30.8%) patients developed GDM and the rest 45 patients had normal glucose tolerance (NGT). The first trimester mean serum irisin concentration was significantly lower in women who later developed GDM compared with women who had NGT (111.65 ± 25.43 μg/L vs 185.89 ± 28.89 μg/L). Serum irisin concentration was the best predictor with an optimal threshold value of 149 μg/L, which had sensitivity, specificity, positive predictive value, and negative predictive value of 90%, 91.1%, 81.8%, 95.3%, respectively, for predicting GDM at 24–28 weeks of pregnancy. Conclusion: We suggest the utility of serum irisin as an early biomarker to predict the development of GDM later in pregnancy in high-risk patients.

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