The silent toll: understanding the complications of type 2 diabetes mellitus in the male body: a narrative review article

Diabetes mellitus (DM) is a significant global health concern, with a higher prevalence in males compared to females. This narrative review explores the biological, hormonal, and psychosocial factors contributing to sex-specific differences in the development, progression, and complications of type 2 diabetes (T2D) in men. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar. The study focused on male-specific complications of diabetes, including cardiovascular disease, sexual dysfunction, neuropathy, renal and ocular complications, mental health, and behavioural influences. Inclusion criteria encompassed peer-reviewed articles focusing on adult males with DM and studies reporting sex-disaggregated data. Men with T2D exhibit distinct clinical features, such as hepatic insulin resistance, testosterone deficiency, and increased susceptibility to erectile dysfunction, cardiovascular complications, and foot ulcers. Testosterone plays a crucial role in glucose metabolism and vascular health, with low levels linked to worsened glycemic control and increased cardiovascular risk. Gender disparities exist in diagnosis and treatment responses, with men often showing lower adherence to screening programs and delayed healthcare-seeking behaviors. Additionally, psychosocial factors such as stigma, masculinity norms, and health literacy significantly influence diabetes management outcomes in men. This review highlights the need for a male-focused approach in diabetes care to improve early detection, personalized therapy, and complication prevention. Tailored interventions addressing hormonal imbalances, cardiovascular risks, sexual health, and psychosocial barriers are essential for optimizing health outcomes in men with diabetes.

Type 2 diabetes; Male-specific complications; Testosterone deficiency; Erectile dysfunction; Cardiovascular disease; Insulin resistance; Sexual health

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