Long-term testosterone therapy may prompt type 2 diabetes remission in men Among men with hypogonadism included in a urology registry,
long-term treatment with testosterone may lead to remission of type 2
diabetes, according to a speaker. “This registry was not designed to
study the effects of testosterone on type 2 diabetes,” Farid Saad, PhD,
of Bayer Pharma in Berlin, said during the presentation. “A remission of
type 2 diabetes with testosterone has not been described in the
literature. It was completely unexpected.”
raw Testosterone decanoate powder Saad and colleagues evaluated data from 400 men included in a urology
registry of patients with hypogonadism (testosterone = 12.1 nmol/L)
since 2004; 133 (33.3%) of them had been diagnosed with type 2 diabetes
and were treated in a diabetes center. All men received injections of
testosterone undecanoate 1,000 mg for 12 weeks for hypogonadism. At
least twice a year, anthropometric and metabolic measurements were
obtained, and fasting insulin was acquired from the diabetes center to
calculate homeostasis model assessment for insulin resistance.
Participants were followed for a mean of 6.9 years, with a maximum of 11
years. At baseline, mean age of the participants was 60 years. The
researchers found that at the final measurement, 16 men (12%) were in
diabetes remission. They observed a reduction in HbA1c from 8.3% at
baseline to 5.7%. Also decreased from baseline to last measurement were
fasting glucose (from 7.8 mmol/L to 5.4 mmol/L) and fasting insulin
(from 24.7 µU/mL to 7.6 µU/mL). HOMA-IR decreased from 8.7 to 1.8, and
triglycerides dropped from 3.2 mmol/L to 2.2 mmol/L. A decrease in body
weight from baseline was observed, from 107 kg to 89 kg, and a reduction
in waist circumference from 108 cm to 97 cm. At baseline, all
participants had been prescribed oral metformin, and five were on a
regimen of insulin at an average dose of 21.6 units per day. Patients
were observed for an average of 106.3 months. Discontinuation of
diabetes medication occurred at an average of 74.8 months. One patient
discontinued testosterone after a diagnosis of low-grade prostate cancer
and, subsequently, developed new-onset type 2 diabetes. This patient
again experience diabetes remission 48 months after resuming
testosterone therapy. Because all injections were given in the urology
office, medication adherence was 100%. Saad weighed the potential
cardiovascular benefits of diabetes remission, weight loss and decreased
lipid levels against assertions that testosterone treatment itself
confers CV risk.
