Oltre il controllo glicemico: ruolo dei nuovi farmaci per la cura del diabete e qualità seminale

In recent years, novel antidiabetic drugs, particularly sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA), have gained attention for their extra-glycaemic effects. Among these, a potential impact on male reproductive function has been suggested. This review critically revises state-of-the-art evidence on the impact of these molecules on spermatogenesis and pathophysiological mechanisms involved, including oxidative stress and testicular inflammation. Preclinical studies indicate that SGLT2i may protect testicular tissue from oxidative damage, improve sperm quality, and preserve Sertoli and germ cell function. Similarly, GLP1-RA have shown favourable actions on sperm parameters in animal models, mediated by metabolic, endocrine, and direct testicular effects. However, evidence in humans remains scarce and partly conflicting, with only preliminary reports suggesting possible reproductive benefits. Dual agonists such as tirzepatide hold promise, but data are still lacking. Overall, prospective clinical trials specifically designed to evaluate reproductive endpoints are required to clarify the real role of these drugs in preserving male gonadal health.