The influence of long term diabetes (5-10 years) on the hypothaThrnic
pituitary gonadal axis was studied in 40 adult (IDDM) patients (20
males &. 20 females) and 30 healthy volunteers (20 male & 10 female) as
a control. Plasma level of LH, FSH, and (testosterone and prolactin in
male and progesterone in female) were measured in both diabetic and
control subjects. They were also measured in diabetic patients after oral
administration of clomiphene citrate in a dose 50 mg /day for 10 days.
Results revealed the following. The base line plasma LH and FSH in diabetic
patients showed different data in males and in females In males,
there were significant increase in the level of LH, FSH and prolactin compared
to the control group. This increase was correlated with a significant
decrease in the level of testosterone, concluding that diabetes Mellitus
has a degenerative changes on the tests ,decreasing the testosterone level
and consequently by the negative feed back mechanism the level of LH
& F314 was increased. In females, the base line level of LH , P314. and
progesterone were significantly decreased which may be due to the effect
of diabetes on the (HPGA ). On the other hand, after treatment with clomiphine
citrate in males, there was significant increase in LH, FSH but with
no change in testosterone level. These data added further support to our
conclusion that the effect of diabetes is mainly at the testicular level more
than central since the treatment increased the negative feed back mechanism
leading to further increase in LH level. The data in the female
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Magdy Z. El-Ghannam et al...
patients after treatment showed significant increase in plasma level of
LH , FSH, and progesterone. But concerning the increase in progesterone
level it can not reach the control level, concluding that the (IDDM) affect
the female reproductive function both centrally at the level of (HPGA) and
locally at the level of the gonads. As a result of these data. clomiphen
citrate can be used in female patients but it is considered of limited value
in male diabetic patients. |
