What role does SHBG play in blood sugar?

SHBG (sex hormone-binding globulin) is produced in the liver and binds testosterone and estradiol. Its blood levels are inversely associated with type 2 diabetes risk: low SHBG correlates with insulin resistance and higher blood glucose. Mechanistically, insulin suppresses SHBG production, while SHBG may directly affect insulin sensitivity – possibly via cellular signaling or by modulating free sex hormone availability. Evidence is mainly from observational and mechanistic studies; robust causal trials are lacking. An SHBG test alone is not diagnostic for blood sugar issues but can provide context in metabolic syndrome assessment. Caveat: SHBG levels are also influenced by liver disease, thyroid function, and medications. Abnormal results require medical follow-up.