Type 2 diabetes mellitus (T2DM) is a multifaceted endocrine and metabolic disorder, which involves not only defects in insulin action and β-cell function. There is some evidence that the chronic hyperglycemia, increased visceral adipose tissue and low-grade inflammation seen in patients affected with T2DM may lead to derangement of hypothalamic–pituitary function and therefore gonadal steroidogenesis, however sex-specific hormonal profile has been poorly described in Middle Eastern individuals. The present case–control study addressed levels of pituitary and gonadal hormones in T2DM adults, and was conducted to assess their association with glycemic control. One hundred adults were recruited (50 patients with T2DM [25 men and 25 women] and 50 age- and sex-matched healthy controls). Anthropometric parameters, fasting plasma glucose (FPG), lipid profile and glycated haemoglobin (HbA1c) were estimated. Serum luteinizing hormone, follicle-stimulating hormone, prolactin, thyroid-stimulating hormone (TSH), testosterone (TT) in men and estradiol (E2) in women were measured with chemiluminescent immunoassays. Patients with T2DM showed higher body mass index, fasting plasma glucose, and HbA1c levels than controls (p < 0.001). Gonadotropin was significantly lower and prolactin, thyroid-stimulating hormone levels were higher in male as well as female patients. Men with T2DM had significantly lower testosterone and affected women had significantly lower estradiol concentration. Glycated hemoglobin significantly negatively correlated with gonadotropins and sex steroids, and positively correlated with prolactin and thyroid-stimulating hormone. These data showed that T2DM was associated with abnormalities in pituitary–gonadal and pituitary–thyroid function (represented by hypogonadism, hyperprolactinemia and thyroid axis alterations), regardless of gender; this finding highlights a need to carry out endocrinological evaluation in poorly controlled patients.