Can Antidiabetic Drugs Improve Male Reproductive (Dys)Function Associated with Diabetes?

Area of Science:

• Endocrinology
• Reproductive Medicine
• Pharmacology

Background:

• Rising global diabetes prevalence poses significant health, social, and economic challenges.
• Diabetes is increasingly linked to male reproductive impairment, exacerbating worldwide fertility decline.
• Therapeutic interventions for diabetes, particularly glycemic control, are essential but their impact on male reproductive health is understudied.

Purpose of the Study:

• To critically assess the existing literature on the effects of various antidiabetic drugs on male reproductive function.
• To highlight the controversies and gaps in knowledge regarding the reproductive safety of non-insulin antidiabetic agents.
• To provide a comprehensive review of different drug classes and their potential impact on male fertility.

Main Methods:

• Systematic literature review of studies investigating antidiabetic medications and male reproductive parameters.
• Analysis of research employing diverse experimental models and methodologies.
• Categorization of antidiabetic drugs including biguanides, sulfonylureas, and SGLT2 inhibitors.

Main Results:

• Insulin's crucial role in male reproduction is confirmed, with deficiency leading to impairment and treatment restoring function.
• Evidence regarding other antidiabetic drug classes (e.g., GLP-1 agonists, DPP-4 inhibitors) is often conflicting.
• Variations in study designs, models, and specific compounds contribute to the heterogeneity of reported outcomes.

Conclusions:

• The impact of most antidiabetic strategies beyond insulin on male reproductive function requires further investigation.
• Clarifying the reproductive safety profile of diverse antidiabetic medications is crucial for managing diabetic patients.
• Addressing these knowledge gaps is vital for preserving male fertility in the growing diabetic population.