Title:Can Antidiabetic Drugs Improve Male Reproductive (Dys)Function Associated with Diabetes?
Volume: 26
Issue: 22
Author(s): R.S. Tavares, S. Escada-Rebelo, M.I. Sousa, A. Silva, J. Ramalho-Santos and S. Amaral*
Affiliation:
- Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra 3004-504 Coimbra,Portugal
Keywords:
Diabetes, infertility, male reproductive function, antidiabetic therapies, SGLT2, diabetic problems, reproductive
dysfunction.
Abstract: The alarming increase in the number of diabetic patients worldwide raises concerns
regarding the impact of the disease on global health, not to mention on social and economic
aspects. Furthermore, the association of this complex metabolic disorder with male reproductive
impairment is worrying, mainly due to the increasing chances that young individuals, at
the apex of their reproductive window, could be affected by the disease, further contributing
to the disturbing decline in male fertility worldwide. The cornerstone of diabetes management
is glycemic control, proven to be effective in avoiding, minimizing or preventing the appearance
or development of disease-related complications. Nonetheless, the possible impact of
these therapeutic interventions on male reproductive function is essentially unexplored. To
address this issue, we have made a critical assessment of the literature on the effects of several
antidiabetic drugs on male reproductive function. While the crucial role of insulin is clear, as
shown by the recovery of reproductive impairments in insulin-deficient individuals after
treatment, the same clearly does not apply to other antidiabetic strategies. In fact, there is an
abundance of controversial reports, possibly related to the various study designs, experimental
models and compounds used, which include biguanides, sulfonylureas, meglitinides,
thiazolidinediones/glitazones, bile acid sequestrants, amylin mimetics, as well as sodiumglucose
co-transporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP1), α-glucosidase
inhibitors and dipeptidyl peptidase 4 (DPP4) inhibitors. These aspects constitute the focus of
the current review.
