Testosterone Deficiency, Fat & Diabetes
Testosterone deficiency & type 2 diabetes go to hand in hand. Obesity is associated with type 2 diabetes and low testosterone, partly because fat cells convert testosterone to oestrogen.
Approximately 40% of men with type 2 diabetes have symptomatic testosterone deficiency
A large government randomised controlled trial in Australia looked at men with pre-diabetes who had a total testosterone less than 14nmol/L . They were randomly assigned treatment with either a lifestyle programme alone, or a lifestyle programme and testosterone undecanoate (Nebido).
The trial showed men treated with testosterone had a 41% reduction in risk of diabetes after two years of treatment.
There is an ongoing worldwide audit of patients with diabetes and testosterone deficiency (low testosterone). The ABCD Testosterone Audit comprises 428 men with types 2 diabetes and hypogonadism, from 34 centres in eight countries. Initial analysis of 121 men at 12 months, showed a drop in HbA1C from a baseline of 71 to 61. At 48 months, the drop was from 71.4 to 55.97, with both showing statistical significance.
Multiple studies have shown testosterone treatment in men who are deficient to provide improvements in bone health, muscle strength, sexual function and psychological well-being. And yet for so many men their hormonal health is completely ignored by medical professionals.
All patients with type 2 diabetes and low testosterone I see are asked if they want their data added to this important audit. We can then build the evidence base further of the importance of testosterone treatment in improving and reversing type 2 diabetes.
If you have type 2 diabetes have you had your testosterone checked? Are you informed on what a ‘normal’ testosterone level is? Do you know what impact your hormonal health is having on your overall health and wellbeing?
References & Resources:
Wittert, G., Bracken, K., Robledo, K. P., Grossmann, M., Yeap, B. B., Handelsman, D. J., Stuckey, B., Conway, A., Inder, W., McLachlan, R., Allan, C., Jesudason, D., Fui, M. N. T., Hague, W., Jenkins, A., Daniel, M., Gebski, V., & Keech, A. (2021). Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM): a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial. The Lancet Diabetes & Endocrinology, 9(1), 32–45. https://doi.org/10.1016/S2213-8587(20)30367-3
Grossmann, M., Thomas, M. C., Panagiotopoulos, S., Sharpe, K., MacIsaac, R. J., Clarke, S., Zajac, J. D., & Jerums, G. (2008). Low testosterone levels are common and associated with insulin resistance in men with diabetes. Journal of Clinical Endocrinology and Metabolism, 93(5), 1834–1840. https://doi.org/10.1210/jc.2007-2177
Kapoor, D., Aldred, H., Clark, S., Channer, K. S., & Jones, T. H. (2007). Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: Correlations with bioavailable testosterone and visceral adiposity. Diabetes Care, 30(4), 911–917. https://doi.org/10.2337/dc06-1426
Medscape: Testosterone Replacement Benefits Men With Type 2 Diabetes. Accessed 20th October 2023 https://www.medscape.com/viewarticle/997431?src=soc_lk_share
ABCD Audit: http://www.diabetologists-abcd.org.uk/Testosterone/Testosterone_Deficiency_Diabetes_Nationwide_Audit.htm
