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Testosterone and Diabetes

10 Jun Uncategorized | Comments Off
Testosterone and Diabetes

Testosterone is a steroid hormone that acts on the prostate, testes, breasts, skin, cardiovascular system, and the respiratory system. Men with type 2 diabetes are two times more likely to have low testosterone than men without diabetes.

Approximately 50% of men with diabetes have low testosterone. Men with low testosterone are at increased risk for developing diabetes, metabolic syndrome, obesity, and cardiovascular disease. Testosterone levels gradually decrease after 30 years of age, by about 1%–2% each year.

Some symptoms of low testosterone include:

  • Decreased libido
  • Erectile dysfunction
  • Decreased lean body mass and strength
  • Osteoporosis
  • Lethargy
  • Emotional changes
  • In one study funded by the UK drugmaker ProStrakan, men who received testosterone gel (as opposed to a placebo gel) decreased their insulin resistance by 16%, improved their cholesterol levels, and slightly improved their sexual function, but did not improve their blood glucose control.

    In another recent study presented at the 19th European Congress on Obesity, middle-aged or older men who were overweight or obese lost weight while using testosterone therapy. The men were treated with testosterone injections for up to 5 years. The men who were treated the longest lost 35 pounds on average and showed improvements in blood pressure, blood glucose, triglycerides, and low-density lipoprotein (LDL) cholesterol.

    More research is needed to confirm these findings. The link between testosterone and possible weight loss is not defined, and it is perhaps secondary to increased energy and activity with initiation of the therapy. Other studies have not, to date, showed significant weight loss following testosterone replacement.

    You can determine testosterone level with lab work. The recommended time for the blood draw is in the morning, between 8 AM and 11 AM. If one result is low, another test is recommended for confirmation before treatment is initiated. Testosterone gels, oral medications, buccal preparations, implantable pellets, patches, or injections are used to treat low testosterone levels. Injections are given weekly or once every 2–3 weeks. Some patients will have symptoms secondary to rapidly fluctuating hormone levels with this method.

    Oral testosterone medications are rarely used in America, secondary to risk for adverse effects, most notably hepatotoxicity. The buccal tablet is used twice a day, held against the upper gums.

    Transdermal options can be scrotal and nonscrotal skin patches or gels. Some men may not absorb enough of the hormone via this route, while other men develop skin irritation (more common with the patch than the gel).

    Testosterone therapy is contraindicated in men with suspected or known prostate cancer or with breast cancer. Sleep apnea and social or mood disorders are considered relative contraindications to testosterone therapy. Men with fertility concerns should use testosterone cautiously, because testosterone therapy impairs spermatogenesis.

    References and recommended readings
    American Association of Diabetes Educators. Men’s health, low testosterone and diabetes: individualized treatment and a multidisciplinary approach. Available at: http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/Mens_Health_White_Paper.pdf. Accessed August 25, 2012.

    American Diabetes Association®. Low testosterone. Available at: http://www.diabetes.org/living-with-diabetes/complications/mens-health/sexual-health/low-testosterone.html. Accessed August 25, 2012.

    Boyles S. Testosterone linked to weight loss in obese men: when levels were low, testosterone replacement led to lost weight, smaller waists. Available at: http://men.webmd.com/news/20120509/testosterone-obesity-drug-older-men. Accessed August 25, 2012.

    Morgentaler A. Testosterone and diabetes: an important link? Available at: http://www.diabeteshealth.com/read/2008/12/15/6018/testosterone-and-diabetesan-important-link/. Accessed August 25, 2012.

    Reuters.com. Testosterone gel shows effects on diabetes. Available at: http://www.reuters.com/article/2011/03/24/us-testosterone-gel-idUSTRE72N7NC20110324. Accessed August 25, 2012.

     

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