Age-Related Androgen Deficiency and Type 2 Diabetes

2011 ◽  
Vol 24 (3) ◽  
pp. 316-322 ◽  
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.

scholarly journals Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes

2013 ◽  
Vol 169 (6) ◽  
pp. 725-733 ◽  
Author(s):  
Vakkat Muraleedharan ◽  
Hazel Marsh ◽  
Dheeraj Kapoor ◽  
Kevin S Channer ◽  
T Hugh Jones
Keyword(s):  
Type 2 Diabetes ◽  
Untreated Group ◽  
Testosterone Replacement ◽  
Testosterone Deficiency ◽  
Testosterone Levels ◽  
All Cause Mortality ◽  
Low Testosterone

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.

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

2008 ◽  
Vol 93 (5) ◽  
pp. 1834-1840 ◽  
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.

RELATIONSHIP BETWEEN PLASMA TESTOSTERONE LEVELS AND RISK FACTORS IN MALE PATIENTS WITH TYPE 2 DIABETES

2013 ◽  
pp. 57-63
Author(s):  
Thi Bach Oanh Nguyen ◽  
Hai Thuy Nguyen ◽  
Cuu Loi Nguyen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Plasma Testosterone ◽  
Diabetic Patients ◽  
Testosterone Levels ◽  
Age Related ◽  
Male Patients ◽  
Type 2 Diabetic

Background: Testosterone is vital hormone for men’s health and a keyplayer in glucose homeostasis, lipid metabolism, and cardiovascular pathology. Testosterone deficiency is associated with age, many chronic health conditions and other metabolic disorders. Objectives: Of this study to assess the concentration of plasma testosterone in male patients with type 2 diabetes, and evaluate the relationship between plasma testosterone levels and the assosiated risk factors. Methods: 54 male patients with type 2 diabetes and 31 non diabetes subjects over 45 years old, were assessed plasma tetosterone and lipidemia concentration and risk factore including age, BMI, waist circumference, blood pressure. Results: The concentration of plasma testosterone in type 2 diabetic male patients was lower than that in normal male subjects (4.5± 1.59 vs 5.27± 1.59 ng/ml, p< 0.05). There was significantly difference of plasma tetosterone levels between diabetic patients and controls of < 60 ages and ≥ 60 ages were respectively (4.07± 1.19 vs 5.36± 1.89 ng/ml) and (4.76± 1.76 vs 5.22 ±1.39 ng/ml, p <0.05). There was correlation between plasma testosterone levels with WC (r = - 0.4242, p< 0.01) and BMI (r = -0.37, p<0.01) and no relationship significatively between plasma testosterone concentration with blood pressure and lipidemia in diabetic patients. Conclusions: Concentration of plasma testosterone in type 2 diabetic male patients was lower than that in healthy subjects of similar age, related with age, VB and BMI. Key words: Testosterone, diabetes, risk factors.

scholarly journals Testosterone Levels and Type 2 Diabetes—No Correlation with Age, Differential Predictive Value in Men and Women

Biomolecules ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. 76 ◽  
Author(s):  
Mahir Karakas ◽  
Sarina Schäfer ◽  
Sebastian Appelbaum ◽  
Francisco Ojeda ◽  
Kari Kuulasmaa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Density Lipoprotein ◽  
Serum Testosterone ◽  
Cross Sectional ◽  
Men And Women ◽  
Testosterone Levels ◽  
Increased Risk ◽  
Low Testosterone ◽  
Future Diabetes

Most studies reporting on the association of circulating testosterone levels with type 2 diabetes in men are of cross-sectional design. Reports on the relevance of altered testosterone levels in women are scarce. Here, we evaluate the role of low serum testosterone levels for incident diabetes in men and women in a population setting of 7706 subjects (3896 females). During a mean follow up time of 13.8 years, 7.8% developed type 2 diabetes. Significant correlations of testosterone with high density lipoprotein (HDL)-cholesterol (R = 0.21, p < 0.001), body-mass-index (R = −0.23, p < 0.001), and waist-to-hip-ratio (R = −0.21, p < 0.001) were found in men. No correlation was found with age in men; in women, the correlation was negligible (R = 0.04, p = 0.012). In men, low testosterone levels predicted high risk of type 2 diabetes, while in women this relationship was opposite. Men with low testosterone levels showed increased risk of future diabetes (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.91–3.72, p < 0.001 in basic model; HR 1.56 95%, CI 1.10–2.21, p = 0.003). In women, low testosterone levels indicated lower risk with (HR 0.53, 95% CI 0.37–0.77, p = 0.003), while the association lost significance in the fully adjusted model (HR 0.72, 95% CI 0.49–1.05, p = 0.09). Low levels of testosterone predicted future diabetes in men. A borderline opposite association was found in women.

Men's Health, Low Testosterone, and Diabetes Individualized

2008 ◽  
Vol 34 (5_suppl) ◽  
pp. 97S-112S ◽  
Author(s):  
Donna Rice ◽  
Robert E. Brannigan ◽  
R. Keith Campbell ◽  
Shari Fine ◽  
Leonard Jack ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Sexual Health ◽  
The United States ◽  
Men’S Health ◽  
Men's Health ◽  
Testosterone Therapy ◽  
Testosterone Levels ◽  
Low Testosterone

Testosterone plays a critical role in male reproductive and metabolic functioning. Serum testosterone levels decrease with age, and low testosterone is associated with a variety of comorbidities, including insulin resistance, type 2 diabetes, obesity, metabolic syndrome, and cardiovascular disease. Men with type 2 diabetes have been shown to have significantly lower testosterone levels than men without diabetes. Several forms of testosterone replacement therapy (eg, oral, injectable, buccal, transdermal preparations) are available for use in the United States. The primary goals of testosterone therapy are to restore physiologic testosterone levels and reduce the symptoms of hypogonadism. Testosterone therapy may be a viable option in some men with diabetes and low testosterone; however, clinicians must be aware of contraindications to therapy (eg, prostate cancer and male breast cancer), implement appropriate monitoring procedures, and ensure that patient expectations are realistic regarding treatment outcome. Data suggest that testosterone therapy may have a positive effect on bones, muscles, erythropoiesis and anemia, libido, mood and cognition, penile erection, cholesterol, fasting blood glucose, glycated hemoglobin, insulin resistance, visceral adiposity, and quality of life. Sexual health may be a window into men's health; thus, more effective communication strategies are needed between clinicians and men with diabetes to ensure that sexual health topics are adequately addressed. Diabetes educators can play a key role in screening for low testosterone, providing relevant information to patients, and increasing clinician awareness of the need to address men's sexual health and implement appropriate strategies. Multidisciplinary care and individualized treatment are needed to optimize outcome.

scholarly journals Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study

2013 ◽  
Vol 20 (3) ◽  
pp. 179 ◽  
Author(s):  
AymanA Al Hayek ◽  
Kamel Ajlouni ◽  
YousefS Khader ◽  
Sahar Jafal ◽  
Nahla Khawaja ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Testosterone Levels ◽  
Low Testosterone

scholarly journals Metabolic and proteomic signatures of type 2 diabetes subtypes in an Arab population

2022 ◽  
Author(s):  
Shaza Zaghlool ◽  
Anna Halama ◽  
Nisha Stephan ◽  
Manonanthini Thangam ◽  
Emma Ahlqvist ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Autoimmune Diabetes ◽  
Treatment Options ◽  
Specific Treatment ◽  
Independent Set ◽  
Arab Population ◽  
Fatty Acid Binding ◽  
Insulin Resistant ◽  
Age Related

Background. Type 2 diabetes (T2D) has a heterogeneous etiology which is increasingly recognized to influence the risk of complications and choice of treatment. A data driven cluster analysis in four separate European populations of patients with type 2 diabetes identified four subtypes of severe insulin dependent (SIDD), severe insulin resistant (SIRD), mild obesity-related (MOD), and mild age-related (MARD) (Ahlqvist et al., Lancet Diabetes Endocrinology, 2018). Our aim was to extend this classification to the Arab population of Qatar and characterize the biological processes that differentiate these subtypes in relation to metabolomic and proteomic signatures. Methods. The Ahlqvist et al. subtype clustering approach was applied to 631 individuals with T2D from the Qatar Biobank (QBB) and validated in an independent set of 420 participants from the same population. The association between blood metabolites (n=1,159) and protein levels (n=1,305) with each cluster were established. Findings. The four subtypes of T2D were reproduced and validated in the population of Qatar. Cluster-specific metabolomic and proteomic associations revealed subtype-specific molecular processes. Activation of the complement system with many features of autoimmune diabetes and reduced 1,5-anhydroglucitol (1,5-AG) characterized SIDD, with evidence of impaired insulin signaling in SIRD, elevated leptin and fatty acid binding protein in MOD, whilst MARD appeared to be the healthiest subgroup. Interpretation. We have replicated the four T2D clusters in an Arab population and identified distinct metabolic and proteomic signatures, providing insights into underlying etiology with the potential to deploy subtype-specific treatment options.

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