Low Testosterone in Obesity and Type 2 Diabetes

ObjectiveMen with type 2 diabetes are known to have a high prevalence of testosterone deficiency. No long-term data are available regarding testosterone and mortality in men with type 2 diabetes or any effect of testosterone replacement therapy (TRT). We report a 6-year follow-up study to examine the effect of baseline testosterone and TRT on all-cause mortality in men with type 2 diabetes and low testosterone.Research design and methodsA total of 581 men with type 2 diabetes who had testosterone levels performed between 2002 and 2005 were followed up for a mean period of 5.8±1.3 s.d. years. Mortality rates were compared between total testosterone >10.4 nmol/l (300 ng/dl; n=343) and testosterone ≤10.4 nmol/l (n=238). The effect of TRT (as per normal clinical practise: 85.9% testosterone gel and 14.1% intramuscular testosterone undecanoate) was assessed retrospectively within the low testosterone group.ResultsMortality was increased in the low testosterone group (17.2%) compared with the normal testosterone group (9%; P=0.003) when controlled for covariates. In the Cox regression model, multivariate-adjusted hazard ratio (HR) for decreased survival was 2.02 (P=0.009, 95% CI 1.2–3.4). TRT (mean duration 41.6±20.7 months; n=64) was associated with a reduced mortality of 8.4% compared with 19.2% (P=0.002) in the untreated group (n=174). The multivariate-adjusted HR for decreased survival in the untreated group was 2.3 (95% CI 1.3–3.9, P=0.004).ConclusionsLow testosterone levels predict an increase in all-cause mortality during long-term follow-up. Testosterone replacement may improve survival in hypogonadal men with type 2 diabetes.

Download Full-text

Testosterone Deficiency, Cardiac Health, and Older Men

International Journal of Endocrinology ◽

10.1155/2014/143763 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

G. Hackett ◽

M. Kirby ◽

A. J. Sinclair

Keyword(s):

Type 2 Diabetes ◽

Replacement Therapy ◽

Risk Groups ◽

Testosterone Replacement ◽

Current Evidence ◽

Testosterone Replacement Therapy ◽

Testosterone Deficiency ◽

Low Testosterone ◽

Low Levels

Low levels of testosterone are manifested by erectile dysfunction, reduced sexual desire, and loss of morning erections with increasing numbers of men are being diagnosed and require treatment. The prevalence rates of testosterone deficiency vary according to different studies but may be as high as 40% in populations of patients with type 2 diabetes. There is increasing evidence that testosterone deficiency is associated with increased cardiovascular and all-cause mortality. Screening for low testosterone is recommended in a number of high risk groups including those with type 2 diabetes and metabolic syndrome. There are recent data to suggest that testosterone replacement therapy may reduce cardiovascular mortality as well as improving multiple surrogate markers for cardiovascular events. Specific clinical trials of testosterone replacement therapy are needed in selected populations but in the meantime we must treat patients based on the best current evidence.

Download Full-text

Age-Related Androgen Deficiency and Type 2 Diabetes

Journal of Pharmacy Practice ◽

10.1177/0897190010397719 ◽

2011 ◽

Vol 24 (3) ◽

pp. 316-322 ◽

Cited By ~ 2

Author(s):

Gina J. Ryan ◽

Lynetta J. Jobe

Keyword(s):

Type 2 Diabetes ◽

Hypogonadotropic Hypogonadism ◽

Treatment Options ◽

Mineral Density ◽

Testosterone Levels ◽

Know How ◽

Age Related ◽

Appropriate Therapy ◽

Low Testosterone

There is a higher prevalence of low testosterone levels in males with type 2 diabetes compared to those without. Additionally, there is evidence that low testosterone levels may predict the development of type 2 diabetes. Symptoms of hypogonadism include decreased libido, decreased bone mineral density (BMD), and decreased lean muscle mass. The majority of the published cases in men with diabetes were attributed to age-related idiopathic hypogonadotropic hypogonadism. This paper reviews the link between type 2 diabetes and age-related hypogonadism and the treatment options for hypogonadism. Pharmacists who provide care for males with diabetes should be aware of the increased incidence of hypogonadism, know how to screen for it, and be able to recommend appropriate therapy.

Download Full-text

Low Testosterone and High C-Reactive Protein Concentrations Predict Low Hematocrit in Type 2 Diabetes

Diabetes Care ◽

10.2337/dc06-0637 ◽

2006 ◽

Vol 29 (10) ◽

pp. 2289-2294 ◽

Cited By ~ 84

Author(s):

V. Bhatia ◽

A. Chaudhuri ◽

R. Tomar ◽

S. Dhindsa ◽

H. Ghanim ◽

...

Keyword(s):

Type 2 Diabetes ◽

C Reactive Protein ◽

Reactive Protein ◽

Low Testosterone

Download Full-text

Low Testosterone: A Risk Marker Rather Than a Risk Factor for Type 2 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-1778 ◽

2016 ◽

Vol 101 (8) ◽

pp. 3180-3190 ◽

Cited By ~ 29

Author(s):

Stine A. Holmboe ◽

Tina K. Jensen ◽

Allan Linneberg ◽

Thomas Scheike ◽

Betina H. Thuesen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Risk Factor ◽

Risk Marker ◽

Low Testosterone

Download Full-text

Low Testosterone Levels Are Common and Associated with Insulin Resistance in Men with Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-2177 ◽

2008 ◽

Vol 93 (5) ◽

pp. 1834-1840 ◽

Cited By ~ 232

Author(s):

Mathis Grossmann ◽

Merlin C. Thomas ◽

Sianna Panagiotopoulos ◽

Ken Sharpe ◽

Richard J. MacIsaac ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Free Testosterone ◽

Total Testosterone ◽

Testosterone Deficiency ◽

Testosterone Levels ◽

Low Testosterone

Abstract Context: Low testosterone levels are common in men with type 2 diabetes and may be associated with insulin resistance. Objective: We investigated prevalence of testosterone deficiency and the relationship between testosterone and insulin resistance in a large cohort of men with type 2 and type 1 diabetes. Design: The study was a cross-sectional survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after a median of 6 months. Results: Forty-three percent of men with type 2 diabetes had a reduced total testosterone, and 57% had a reduced calculated free testosterone. Only 7% of men with type 1 diabetes had low total testosterone. By contrast, 20.3% of men with type 1 diabetes had low calculated free testosterone, similar to that observed in type 2 diabetes (age-body mass index adjusted odds ratio = 1.4; 95% confidence interval = 0.7–2.9). Low testosterone levels were independently associated with insulin resistance in men with type 1 diabetes as well as type 2 diabetes. Serial measurements also revealed an inverse relationship between changes in testosterone levels and insulin resistance. Conclusions: Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention, whereas the utility of testosterone replacement remains to be established in prospective trials.

Download Full-text