Diabetes mellitus is a global epidemic contributing to the rising male infertility rates. Addressing testicular dysfunction in diabetic patients requires a multimodal strategy encompassing medication, lifestyle changes, early diagnosis, and innovative treatments targeting specific biochemical pathways. This review explores the mechanisms of diabetes-induced testicular dysfunction and potential intervention targets. A comprehensive literature search was conducted using PubMed, Science Direct, Google Scholar, and Web of Science with keywords related to diabetes and testicular dysfunction. Diabetes leads to reduced testosterone synthesis, decreased spermatogenesis, increased germ cell apoptosis, and damage to Leydig and Sertoli cells. Mechanisms involved in the pathogenesis of diabetes-induced testicular dysfunction include: hyperglycaemia oxidative stress, inflammation, apoptosis and disrupted hormone levels among others. Targeting biomolecular regulators involved in the pathogenic pathways offers a promising therapeutic avenue. Additionally, exploring plant-based therapies as alternative treatments shows potential in alleviating testicular dysfunction in diabetes. Implementing a comprehensive approach combining diagnostics, pharmacological interventions, and lifestyle modifications is crucial in managing testicular dysfunction in diabetic individuals. Future research directions suggest the need for large-scale clinical trials, personalized medicine strategies, and innovative technologies to address and mitigate testicular dysfunction in diabetic populations effectively.
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