scholarly journals Diagnosis and treatment of testosterone deficiency in type 2 di abetes mellitus

2018 ◽  
Vol 23 (4) ◽  
pp. 314-322
Author(s):  
V.E. Luchitsky

The purpose — to optimize approaches to the diagnosis and treatment of testosterone deficiency in men with type 2 diabetes mellitus. Materials and methods. We examined 147 men with type 2 diabetes at the age from 28 to 75 years old. The definition of testosterone total (cT), free testosterone (fT), estradiol (E2), sex steroid-binding globulin (CSHG), dihydrotestosterone (DHT), prostate-specific antigen total (PSA) in serum by immune-enzymatic method was performed. Substitution therapy with testosterone preparations was carried out by us to 89 patients. Results. Our studies conducted among men with type 2 diabetes have found a decrease in the mean T blood level in patients with type 2 diabetes compared with the control. The mean levels of DHT were lowered compared to control. The average levels of E2 did not differ from those of the control. The average concentration of CSHG was reduced compared to control. On the background of testosterone therapy, stabilization of the level of total testosterone at the level of eugonadal values was observed in men who received testosterone substitution after 3 months of therapy. Conclusions. Men with diabetes type 2 need to be checked for testosterone concentration annually. In the case of a decrease in T level below 8 nmol/l it is necessary to conduct substitution therapy. In cases where T levels are within the ≪gray zone≫ of 12-8 nmol/l, additional laboratory tests are needed: the determination of free T levels, estradiol, CSHG.

2012 ◽  
Vol 19 (4) ◽  
pp. 397-403 ◽  
Author(s):  
Rucsandra Dănciulescu Miulescu ◽  
Suzana Dănoiu ◽  
Denisa Margină ◽  
Sorin Păun ◽  
Cătălina Poiană

AbstractObjectives. Prostate-specific antigen (PSA) is the most used and validated marker ofprostate cancer risk. The aim of this study was to assess PSA levels during treatmentwith testosteronum undecanoat in patients with type 2 diabetes (T2DM). Material and Methods. We evaluated 38 T2DM patients aged between 48 and 61 years withconfirmed hypogonadism. 1000 mg testosterone undecanoate was injectedintramuscular every 10 to 14 weeks. Total testosterone and PSA levels were assessedat baseline and after 6, 12, 24 months of treatment. Results. The average age was55.03 ± 2.40 years and 3 patients (7.89%) had a family history of prostate cancer.Treatment with testosterone undecanoate generated significant changes in serumtotal testosterone (482.29±50.78 ng/dl vs. 246.66±51.50 ng/dl, p < 0.001) but not inserum PSA levels (2.11±.0.49 ng/ml vs. 2.09±0.47 ng/ml, p - NS). Conclusion.Testosterone replacement therapy may normalize serum androgen levels but appearsto have little effect on PSA levels.


2018 ◽  
Vol 7 (1) ◽  
pp. 220-231 ◽  
Author(s):  
Qiu-ming Yao ◽  
Bin Wang ◽  
Xiao-fei An ◽  
Jin-an Zhang ◽  
Liumei Ding

Background Type 2 diabetes is a risk factor for testosterone deficiency and impaired sex steroid status. Some studies also investigated the association of testosterone level with diabetes risk in men, but reported controversial findings. To clarify this issue, we conducted a systematic review and meta-analysis. Methods PubMed, EMBASE and Web of Science were searched for eligible cohort or nested case–control studies published up to August 15, 2017. Meta-analysis was used to calculate the pooled relative risk (RR) of type 2 diabetes associated with higher testosterone level. Results Thirteen cohort or nested case–control studies with 16,709 participants were included. Meta-analysis showed that higher total testosterone level could significantly decrease the risk of type 2 diabetes in men (RR = 0.65; 95% CI 0.50–0.84; P = 0.001), and higher free testosterone level could also decrease the risk of type 2 diabetes in men (RR = 0.94; 95% CI 0.90–0.99; P = 0.014). After excluding two studies that did not calculate RRs by quartiles of testosterone levels, both higher total testosterone and free testosterone levels could decrease the risk of type 2 diabetes in men, and the pooled RRs were 0.62 (95% CI 0.51–0.76; P < 0.001) and 0.77 (95% CI 0.61–0.98; P = 0.03), respectively. Conclusion This meta-analysis suggests that higher testosterone level can significantly decrease the risk of type 2 diabetes in men. Therefore, combined with previous researches, the findings above suggest a reverse-causality scenario in the relation between testosterone deficiency and risk of type 2 diabetes in men.


2008 ◽  
Vol 93 (5) ◽  
pp. 1834-1840 ◽  
Author(s):  
Mathis Grossmann ◽  
Merlin C. Thomas ◽  
Sianna Panagiotopoulos ◽  
Ken Sharpe ◽  
Richard J. MacIsaac ◽  
...  

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.


Author(s):  
Nils Postel ◽  
Eva Wolf ◽  
Annamaria Balogh ◽  
Martin Obermeier ◽  
Olaf Degen ◽  
...  

Abstract Introduction HIV infection has become a chronic, well-treatable disease and the focus of caretakers has shifted to diagnosis and treatment of comorbidities. Hypogonadism in elderly men with HIV might be of particular relevance, however, little is known about its epidemiology in contrast to non-infected peers and men with other chronic medical conditions, such as type 2 diabetes. This study aimed at comparing the prevalence of testosterone deficiency and functional hypogonadism in men ≥ 50 years in these three groups. Patients and Methods Multi-center, cross-sectional substudy of the German-wide 50/2010 study, including men aged 50 years or older with HIV-infection, type 2 diabetes, and controls. Results Altogether, 322 men were included (mean age: 62 years (SD±7.9)). The prevalence of testosterone deficiency in men living with HIV, type 2 diabetes, and controls was 34.5, 44.9, and 35.0%, respectively; the prevalence of functional hypogonadism was 7.7, 14.3 and 3.5%, respectively. Single-factor ANOVA demonstrated significant differences between the groups for total testosterone (p<0.001), SHBG (p<0.001), as well as for free testosterone concentrations (p=0.006). Comorbidities were, however, most important single factor in multi-factor analysis. Discussion Despite a comparable prevalence of testosterone deficiency, functional hypogonadism was more frequent in men living with HIV when compared to non-infected controls. This was the result of a higher burden of symptoms that might, however, also be secondary to other conditions. Number of comorbidities was a more important factor than belonging to one of the groups.


Author(s):  
Saurabh Agarwal ◽  
Brijesh Kumar ◽  
Sushmita . ◽  
Richa Giri ◽  
Sanjay Kumar Verma

Background: Diabetes mellitus is major public health issue facing the world in present century and the prevalence of type 2 diabetes is increasing explosively.  There are various diabetes related complications, one of which is low testosterone levels in men. This study was designed to estimate the serum testosterone level in male patients of type 2 diabetes mellitus.Methods: The patients of type -2 diabetes mellitus were picked up from out-patient and in-patients section of the hospital at random.Results: Seventy male  patients with type 2 diabetes mellitus were enrolled during the study period. The mean age of study population was 56.36±10.26 years (range 36-70), while that of control group patients was found to be 39.80±7.92years. Family history of diabetes was present in 14 (22.2%) patients. The mean HbA1c in study group was 8.83±1.95 %, which was significantly higher as compared to control group with HbA1c 4.82±0.40 %. Among study group, lower serum total testosterone level was observed in 85.7 % cases and normal level in 14.3 % cases. Among control group, lower serum total testosterone level was observed in 6.7 % cases and normal level in 93.3 % cases.Conclusions: The present study highlighted that significant difference in serum total testosterone level has been observed between cases and control groups (X2 =55.7, P=0.0001).


2019 ◽  
Author(s):  
Irina Khripun ◽  
Sergey Vorobyev ◽  
Ekaterina Petrovskaya ◽  
Natalia Kuzmenko

Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.


Author(s):  
Sultan Ayoub Meo ◽  
Abdulelah Adnan Abukhalaf ◽  
Ali Abdullah Alomar ◽  
Omar Mohammed Alessa ◽  
Omar Yassin Sumaya ◽  
...  

Sports offer great benefits, improving health and reducing the risk of illnesses. This study’s aim was to investigate the prevalence of prediabetes and type 2 diabetes mellitus in football players compared to population based non-elite athlete control subjects. Initially 1100 male volunteers, (550) football players, and (550) population based non-elite athlete control subjects were interviewed. After socio-demographic and medical history analysis, 756 (378) nonsmoker male football players and (378) nonsmoker male control subjects were recruited. The control subjects were not involved in regular sports activities such as football, volleyball, badminton, cricket, hockey, and swimming. Participants with a known history of anemia, blood diseases, diabetes mellitus, and malignancy were excluded from the study. The mean age of football players was 31.80 ± 5.46 years, Body Mass Index (BMI) was 26.40 ± 2.08 (kg/m2), and the mean age of control subjects was 32.32 ± 4.37 years, and BMI was 26.66 ± 1.87 (kg/m2). The selected football players have been playing football for about 2 h a day, 3 days per week, and so the total mean duration of playing football was 1.08 years. American Diabetes Association (ADA) based criteria on Glycated Hemoglobin (HbA1c) was used to investigate prediabetes and type 2 diabetes mellitus. In football players the prevalence of prediabetes was 30 (7.93%) and type 2 diabetes mellitus (T2DM) was 6 (1.59%) compared to population based matched non-elite athlete control subjects where the prediabetes was 71 (18.78%) and T2DM was 89 (23.54%) (p = 0.001). Among football players there was a 7-fold decrease in T2DM compared to control subjects. Football recreational activities markedly reduce the prevalence of prediabetes and T2DM. The study findings demonstrate the benefits of football and other such sport activities and emphasize the urgent need for promoting football based physical activities as a physiological preventive strategy against the globally growing diabetes epidemic.


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