In a nutshell
This study examined the effect of testosterone replacement therapy on T2D in men with hypogonadotrophic hypogonadism.
Some background
One third of men with type 2 diabetes (T2D) have hypogonadotrophic hypogonadism (HH). HH is a condition in which the brain fails to produce follicle stimulating hormone (FSH) and leutinizing hormone (LH). Both hormones are involved in sperm production and the production of testosterone (hormone responsible for the development of male sexual characteristics). Men with HH can be given testosterone replacement therapy.
T2D is caused by the development of insulin resistance (reduced ability of insulin to lower blood glucose levels). It is unknown whether testosterone replacement therapy affects insulin resistance in T2D men with HH.
Methods & findings
This study aimed to determine the effect of testosterone replacement therapy on insulin resistance in T2D men with HH. This study involved 94 men with T2D. 50 men had healthy functioning gonads. 44 men had HH.
Men with HH were divided into 2 groups. 22 men received 250 mg of intramuscular testosterone every 2 weeks for 24 weeks. The remaining 22 men received a placebo (substance with no therapeutic effect). Insulin resistance was measured using the glucose infusion rate (GIR). The GIR is how much glucose is needed to maintain a certain blood glucose level. A low GIR indicates high insulin resistance.
In comparison to men with healthy testes, men with HH had greater fat mass. Men with HH also had greater insulin resistance (36% lower GIR).
The GIR increased by 32% after 24 weeks in men receiving testosterone therapy. GIR did not change in men receiving the placebo. Fat mass decreased by 3.3 kg after testosterone treatment. Lean mass (body weight that is not fat, such as muscle) increased by 3.4 kg after testosterone treatment.
The levels of free fatty acids (fats in the blood, such as triglycerides) in the blood were lower in men treated with testosterone. C-reactive protein, a marker of inflammation, also decreased in men treated with testosterone.
The bottom line
This study concluded that testosterone replacement therapy reduced insulin resistance, increased lean mass and reduced fat mass in T2D men with HH.
The fine print
This study was only carried out for 24 weeks. Longer studies may be necessary to assess the long-term effects of testosterone treatment.
What’s next?
Consult your physician regarding the risks and benefits of testosterone replacement therapy for the treatment of HH.
Published By :
Diabetes Care
Date :
Nov 29, 2015
