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Curr Med Chem. 2018 Nov 1. doi: 10.2174/0929867325666181101111404. [Epub ahead of print]

Can antidiabetic drugs improve male reproductive (dys)function associated with diabetes?

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1
Biology of Reproduction and Stem Cell Group, CNC- Center for Neuroscience and Cell Biology, University of Coimbra 3004-504 Coimbra. Portugal.

Abstract

The alarming increase in the number of diabetic patients worldwide raises concerns regarding its impact on global health, not to mention on social and economic aspects. Furthermore, the association of this complex metabolic disease with male reproductive impairment is worrying, mainly due to the increasing chances that young individuals, at the acme 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 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 Metformin, Sulphonylureas, Meglitidines, Thiazolinediones/Glitazones, Bile acid sequestrants, amylin mimetics, as well as SLGT2, GLP1, α glucosidase and DPP4 inhibitors. These aspects constitute the focus of the current review.

KEYWORDS:

Diabetes ; Infertlity ; Male reproductive function ; antidiabetic treatments ; insulin ; metformin ; sulfonylureas ; thiazolinediones.

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