Glucose variability and semen quality in young adults with type 1 diabetes using continuous glucose monitoring
Authors' conclusion
In our cohort, both chronic hyperglycemia and short-term glycemic variability are independently associated with impaired semen parameters, suggesting that, beyond HbA1c optimization, reducing glucose variability may represent a therapeutic target to preserve male fertility.
Study context
- Population
- Men with T1DM followed at the University of Campania “Luigi Vanvitelli” Diabetes Center, with continuous glucose monitoring (CGM)-derived parameters collected in the 14 days before semen analysismen with T1DM included
- Participants
- 88 men
- Exposure
- High vs low glycemic variability
- HIGH VARIABILITY (coefficient of variation (CV)≥36%)n = 52
- LOW VARIABILITY (CV<36%)n = 36
- Outcome
- Semen quality
Main finding
As reported in the abstract
- Semen quality significantly reduced in the high-variability group, with lower ejaculate volume, total sperm count, progressive motility, and typical forms
Observational data: associations, not effects.
Further findings
Normozoospermia, univariate analyses
- Normozoospermia positively associated with age and time in range (TIR) and negatively associated with HbA1c, CV, TAR2, and TBR2
Altered semen quality, multivariate logistic regression
- Age, OR (95% CI 0.580-0.868), p<0.001
- 0.710
- HbA1c, OR (95% CI 1.959-7.912), p<0.001
- 3.937
- CV, OR (95% CI 1.021-1.301), p=0.022
- 1.152
- Independent predictors of altered semen quality
Baseline characteristics
- Men with CV ≥36% were younger, had longer diabetes duration, and higher insulin doses than those with CV<36%
Original publication
Glucose variability and semen quality in young adults with type 1 diabetes using continuous glucose monitoring. J Clin Endocrinol Metab. Published 11 November 2026. doi:10.
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