Introduction: Poorly controlled type 1 diabetes affects the hypothalamic pituitary axis and is likely to have a negative impact on spermatogenesis and result in infertility. Further, a chronic complication of diabetes may also be angiopathy of testicular vessels. Thus, at our center for children with diabetes, testicular ultrasound evaluation is performed on adolescent boys with duration of diabetes> 2 years.
Objective: To perform the ultrasound examination of the testis in boys with poorly controlled diabetes with disease duration of > 2 years.
Methodology: Adolescent boys with T1D with disease duration of > 2 years attending diabetes out patient clinic for underprivileged children in a tertiary level care pediatric endocrine unit in Pune, India, were included in the study. Demography, age, disease duration, anthropometry, treatment history and associated illnesses were recorded. HbA1c was assessed and complications were screened. Complications screening included testing for retinopathy, neuropathy and nephropathy. USG scrotum was performed to assess testicular volume and additional findings were noted. Data analysis was performed using SPSS 25.
Results: A total of 94 boys were studied with a mean age of 14.5±3.8 years, mean disease duration was 5.8±2.1 years; mean height and BMI Z scores were -0.75±1.1 and -0.71±1.3 respectively. The mean right testicular volume and Z score were 6.3±4.7 cc and -0.9±0.9 respectively. The mean left testicular volume and Z score were 6.3±4.8 cc and 0.3±0.5 respectively. Mean HbA1c was 10.7±1.9% at the time of study. Last 5 years average HbA1c was 10.7±1.9%. Microlithiasis was observed in 11 patients (11.7%) and 17 (18%) had a prominent mediastinum. There was difference in HbA1c and complications those who had microlithiasis vs those who did not had.
Conclusion: Testicular volume though small was within the reference range among poorly controlled patients with T1D. Testicular Microlithiasis was noted in 11% patients. Given the higher incidence of testicular tumors and impaired fertility, performing testicular USG is important.
19 Sep 2019 - 21 Sep 2019