Nav: Home

Testosterone treatment over 10 years can improve or reverse type 2 diabetes in men with low testosterone, and induce significant weight loss

October 02, 2018

New research presented at this year's annual meeting of the European Association for the Study of Diabetes (EASD) reveals that in men with low testosterone who have type 2 diabetes (T2D), testosterone therapy can improve their disease and reverse its progress, and can also induce significant weight loss.

The research was conducted by Dr Farid Saad, Bayer AG, Berlin, Germany, and colleagues. The aim of the study was to determine the effect of long-term testosterone therapy (TTh) on hypogonadal men (those with low testosterone production) who had T2D. Numerous experimental and clinical studies have shown that TTh can have beneficial effects in hypogonadal men with T2D.

The study population was selected from a group of 805 men with low testosterone, of whom 311 had T2DM and participated in the research. These were split into two groups; a T-group of 141 men who opted for TTh and were given 1000mg injections of testosterone undecanoate every 12 weeks, and the remaining group of 170 men who did not wish to receive this treatment acted as the control group.

The participants were followed up 1-4 times per year when blood samples were taken and their weight and waist measurements were recorded. Their diabetic state was quantified by measuring fasting blood glucose and glycated haemoglobin (HbA1c); levels of which both rise in diabetic patients due to the body having poor control over blood sugar. Fasting glucose gives a measurement of the current state of blood sugar, while HbA1c acts as a measure of the 3-month average of blood glucose levels.

By the end of the 10-year follow-up period, average fasting blood glucose levels decreased in the T-group from 7.7 to 5.3 mmol/L, while in the control group, it rose from 6.3 to 8.2 mmol/L. Average levels of HbA1c also fell in the T-group from 9.0 to 5.9%, and increased in the control patients from 7.8 to 10.6%. This indicated that among the T-group, their T2DM had become less severe, while it had worsened in the untreated controls.

The 61 patients in the T-group who relied on insulin to control their diabetes were able to reduce their dose significantly, falling from an average 34 to 19.9 units per day. Members of the untreated control group saw their average insulin dose rise from 30.7 to 42.2 units per day.

Changes were also observed in weight and waist size measurements of participants. Average weight of T-group members reduced from 113.4 to 90.7 kg at the end of the 10-year study period, and their average waist size dropped from 112.6 to 99.6 cm. Weight and waist circumference of untreated control group patients remained stable throughout the period of the research and no significant reduction of either was observed.

Patients with diabetes are often given a target HbA1c level as a way of measuring the success of any treatments for their disease, which is typically set at either 6.5 or 7.0%. In the control group, there were no patients who reached either target, while in the T-group 80.1% achieved the 6.5% target, and 90.8% reached the 7.0% HbA1c level by the time of the last measurement. Those who did not reach their targets were men who had been treated with testosterone for the shortest duration.

One of the concerns with testosterone therapy in middle aged and elderly men is the persistent fear of inducing prostate cancer. The authors say guidelines by both the European and American Associations of Urology agree that there is no evidence for this assumption. In the present study, the incidence of prostate cancer was in fact twice as high in the untreated control patients as in the testosterone-treated patients.

"The other concern is an increase in haemoglobin and haematocrit which, however, may be a beneficial effect of testosterone rather than a side effect. Testosterone effectively treats anaemia which is not so rare in an elderly population, and anaemia itself presents a cardiovascular risk," explains Dr Saad. "A substantially elevated haematocrit occurred very rarely in this study and was always transient in that it returned to normal with the next measurement. There was not a single heart attack or stroke in the testosterone-treated group, events one may associate with an increase in haematocrit."

The authors conclude: "Long-term testosterone therapy can support diabetes treatment in hypogonadal men with T2D. Its use improved the control of blood glucose, while it deteriorated in patients who had opted not to receive TTh. There were also significant reductions in both weight and waist size in the T-group, which we suggest could have contributed to the observed effects."

Patients in the T-group who were on insulin could have their dose substantially reduced, and the team note that: "Since all injections were administered in the doctor's office and documented, we know that there was 100% adherence to the testosterone therapy used in this study."

They plan a continuation of this registry study for at least another 5 years. They add: "The results, especially in the diabetic subgroup, are becoming increasingly interesting as we had the first patients who went into remission, some after as many of 10 years of testosterone treatment."
-end-


Diabetologia

Related Diabetes Articles:

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.
Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.
Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).
Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.
People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.
Diabetes, but not diabetes drug, linked to poor pregnancy outcomes
New research indicates that pregnant women with pre-gestational diabetes who take metformin are at a higher risk for adverse pregnancy outcomes -- such as major birth defects and pregnancy loss -- than the general population, but their increased risk is not due to metformin but diabetes.
New oral diabetes drug shows promise in phase 3 trial for patients with type 1 diabetes
A University of Colorado Anschutz Medical Campus study finds sotagliflozin helps control glucose and reduces the need for insulin in patients with type 1 diabetes.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
More Diabetes News and Diabetes Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Making Amends
What makes a true apology? What does it mean to make amends for past mistakes? This hour, TED speakers explore how repairing the wrongs of the past is the first step toward healing for the future. Guests include historian and preservationist Brent Leggs, law professor Martha Minow, librarian Dawn Wacek, and playwright V (formerly Eve Ensler).
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.