The purpose — to optimize approaches to the diagnosis and treatment of testosterone deficiency in men with type 2 diabetes mellitus. Materials and methods. We examined 147 men with type 2 diabetes at the age from 28 to 75 years old. The definition of testosterone total (cT), free testosterone (fT), estradiol (E2), sex steroid-binding globulin (CSHG), dihydrotestosterone (DHT), prostate-specific antigen total (PSA) in serum by immune-enzymatic method was performed. Substitution therapy with testosterone preparations was carried out by us to 89 patients. Results. Our studies conducted among men with type 2 diabetes have found a decrease in the mean T blood level in patients with type 2 diabetes compared with the control. The mean levels of DHT were lowered compared to control. The average levels of E2 did not differ from those of the control. The average concentration of CSHG was reduced compared to control. On the background of testosterone therapy, stabilization of the level of total testosterone at the level of eugonadal values was observed in men who received testosterone substitution after 3 months of therapy. Conclusions. Men with diabetes type 2 need to be checked for testosterone concentration annually. In the case of a decrease in T level below 8 nmol/l it is necessary to conduct substitution therapy. In cases where T levels are within the ≪gray zone≫ of 12-8 nmol/l, additional laboratory tests are needed: the determination of free T levels, estradiol, CSHG.
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