Effects of Diabetes on Electrolytes and Testosterone

by Benjamin Bunting BA(Hons) PGCert

ben bunting BA(Hons) PgCert Sport & Exercise Nutriton  Written by Ben Bunting: BA(Hons), PGCert. Sport & Exercise Nutrition. L2 Strength & Conditioning Coach.

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If you have diabetes, you may wish to know how this condition may affect androgens and the electrolytes which help regulate fluid balance and chemical reactions.

In a 2012 study, the researchers aim to find out the effects of type 1 diabetes on serum electrolytes and testosterone levels. Twenty normal male subjects and 20 diabetic men were enrolled in the experiment.

Serum samples were collected in plain sample bottles and spun. The serum was decanted into another plain bottle and the electrolytes and testosterone were determined.  

Diabetes, Electrolytes, and Testosterone

What is the relationship between diabetes, electrolytes, and testosterone?

One study found that men with type 1 diabetes had higher concentrations of testosterone than those with type 2. The difference was statistically significant, and the researchers concluded that both types of diabetes affect the levels of these hormones. However, this correlation is not absolute. The researchers also noted that low concentrations of testosterone are associated with higher risk of cardiovascular events.

There are mixed studies regarding the relationship between low T and cardiovascular disease, although recent studies show that testosterone replacement therapy (TRT) improves insulin sensitivity and glycemic control. In men with type 2 diabetes, TRT significantly reduces body weight and improves endothelial function. This treatment has positive effects on sexual function and quality of life.

Type 2 diabetes mellitus (T2DM)

Men with T2DM show decreased levels of testosterone (T), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This result may be related to the insulin resistance that causes reduced utilization of glucose by the anterior pituitary cell, which results in hypogonadotrophic hypogonadism. A high proportion of men with T2DM are sexually dysfunctional, and low levels of testosterone and LH may indicate the disease. Patients with this condition may have lower levels of high-density lipoprotein (HDL-C) and a lower testosterone level than healthy men.

Lifestyle interventions alone do not treat HG in men with T2DM. Combining testosterone therapy with a lifestyle intervention is likely to improve symptoms. The study is limited by numerous shortcomings, including underpowered studies, short-term follow-up, non-homogeneous cohorts, and inbuilt bias. But a recent meta-analysis found that T2DM affects men with a lower level of testosterone than healthy men.

How Does Diabetes Affect Electrolyte Levels?

In type 1 diabetes, the electrolytes levels in the bloodstream are out of balance. This leads to complications such as kidney failure, a kidney stone, and hypertension. 

The main symptoms of diabetes include increased urination, thirst, weight loss, and blurred vision. In addition to these signs, a decrease in potassium levels may signal the start of a kidney disease. In a study, electrolyte levels in diabetic subjects were lower than those of control subjects. Serum levels of sodium, potassium, calcium, and chloride showed marked changes in diabetic subjects. These changes were observed when the diabetic subjects' blood glucose levels were compared with those of normal controls.

Generally, discussions about diabetes' effects on electrolyte levels focus on abnormalities in serum and plasma sodium concentrations. While these abnormalities are common, they are not usually associated with diabetic ketoacidosis or other complications of diabetes. In fact, they may be the result of other, less dangerous conditions, such as hypomagnesemia and hyperkalemia. 

Fluid Imbalance

High blood sugars cause water to leave cells and move to extracellular spaces, depleting sodium. This fluid is then excreted by more frequent urination, resulting in an electrolyte imbalance. When blood sugars become uncontrolled, many other processes within the body are affected. If the electrolyte balance becomes out of whack, the effects can be disastrous. You may even experience kidney failure and require dialysis.

Similarly, there are other effects of diabetes on testosterone hormone levels. A study on diabetic male subjects found a significant increase in serum sodium levels, while little or no change was noted in potassium levels. In addition, the study found that the concentration of testosterone was significantly lower in diabetic men than in control ones. This data does point to the risks that diabetes poses to serum potassium and sodium levels.

The authors discussed three mechanisms of hypokalemia in diabetes. In one study, poorly controlled DM was associated with hypernatremia. This was due to a decrease in the concentration of sodium in the kidney. Furthermore, diuretic urine causes hypotonic renal loss of potassium. Thus, hypokalemia in diabetic patients is a risk factor for hyperglycemia. If you have diabetes, you should stay hydrated!

In addition to these risks, diabetic patients are at risk for developing hyperglycemia, which is a potentially life-threatening metabolic derangement. According to the American Diabetes Association, approximately 25 million Americans have diabetes and 79 million have pre-diabetes. To help prevent life-threatening hyperglycemia, diabetic patients must learn about the symptoms and treatment options. 

Low potassium levels can lead to seizures and muscle cramps. Some recent studies suggest a link between low potassium levels and type 2 diabetes. Nonetheless, more research is needed to clarify the role of potassium in diabetes. In the meantime, dietary changes may be the most effective treatment. And even if diabetes does not directly lead to an increased risk of type 2 diabetes, it is still a good idea to consume potassium rish foods to keep your blood sodium levels normal.

Cardiovascular disease

One of the many intriguing questions in medicine is how cardiovascular disease and diabetes affect testosterone levels. Many studies have implicated testosterone as a potential risk factor for CVD. Researchers have also looked at how testosterone affects epicardial fat thickness, which has been linked to CVD. This accumulation may be caused by the release of inflammatory adipokines from the adipose tissue.

A recent study from the Hitsumoto Medical Clinic in Yamaguchi, Japan examined the relationship between serum total testosterone levels, cardio ankle vascular index (CAVI), and various clinical parameters. The study included 238 postmenopausal men who were receiving hormonal therapy for angina. Patients taking testosterone therapy increased their mean time to 1-mm ST-segment depression on exercise stress testing, and they had higher coronary vasodilation during exercise stress tests. The authors noted that testosterone treatment also increased the rate of coronary vasodilation in patients with angina.

Studies have shown that testosterone and electrolytes in the serum of men with diabetes are affected by the disease. Testosterone levels are a key factor in determining fat deposition in the body, and they can increase or decrease in men with diabetes. Testosterone helps to maintain bone mineral density and regulates metabolism. This hormone also influences the body's ability to store fat, which can be either subcutaneous or visceral. Both types of fat can increase the risk of developing type 2 diabetes.

In one study, the researchers examined 2416 community-dwelling Swedish men and found that the level of endogenous total testosterone inversely correlated with the risk of major adverse cardiovascular events. Moreover, those in the fourth quartile of total testosterone had an improved event-free survival. This study has raised the bar for future studies. Diabetes, therefore, may affect the function of the adrenal glands. This is why there are many studies examining these effects.

Conclusion

One essential issue with diabetes is that how much glucose in the blood can counterbalance the extent of serum electrolytes. The relationship between blood glucose and serum electrolytes is a complicated one and is connected with various different factors like age and related conditions.

Serum electrolyte imbalance in type 1 diabetes is basically a consequence of raised blood glucose. With hyperglycemia, the body attempts to free itself of the overabundance blood glucose by increasing urinary excretion. Increased urine means fluid and electrolyte loss, which then disturbs the body's equilibrium of electrolytes. The equilibrium is particularly upset among sodium and potassium.

Therefore, serum electrolytes imbalnce adds to the complications with type 1 diabetes and it can probably prompt kidney failure, kidney stones, hypertension and cardiovascular arrythymias because of increase in sodium level (Hypernatremia) and increase in potassium level (Hyperkalemia).

Likewise, there is a higher likelihood of infertility because of testosterone deficiency and this can prompt hypogonadism.

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