Long-term outcomes of testosterone therapy in patients with Type 2 diabetes

This study investigated the long-term outcomes of testosterone replacement therapy in men with erectile dysfunction and Type 2 diabetes (T2D). This study concluded that long-term testosterone therapy may help improve glycemic (blood sugar) control, weight, and waist circumference in these patients.

About 70% of men with T2D have hypogonadism, a condition characterized by low levels of testosterone (the main male sex hormone) in their blood. This can lead to conditions such as erectile dysfunction.

Hypogonadism is treated with testosterone replacement therapy. This therapy has been shown to improve insulin levels, weight, and waist circumference in men with and without T2D. The long-term outcomes of men with T2D and low testosterone levels after testosterone replacement therapy remain under investigation.

This study involved 233 men with T2D and low testosterone levels. Patients were divided into two groups: treated (testosterone therapy) and untreated (no therapy). Patients were followed-up for an average of 3.8 years.

After 30 weeks, HbA1c (average blood glucose over 3 months) was significantly reduced by 0.44% in patients who received testosterone therapy compared to those who did not.

After 30 weeks, weight loss was significantly higher in patients who received testosterone therapy compared to those who did not (1.2 kilograms vs. 0.1 kilograms). However, at 82 weeks, weight loss was not significantly different between both groups.

After 30 weeks, waist circumference significantly decreased in patients who received testosterone therapy compared to those who did not (3.0 centimeters vs. 0.6 centimeters). After 82 weeks, this reduction was even greater (4.8 centimeters vs. 2.1 centimeters).

After 30 weeks, erectile dysfunction significantly improved by 2.9 points in patients who received testosterone therapy compared to those who did not. At 82 weeks, this improvement was 4.9 points.

Overall, there was no significant difference in the number of heart side effects (events) in treated versus non-treated patients (10 events vs. 26 events). Prostate-related events were also not significantly different between both groups (4 events vs. 10 events).

This study concluded that long-term testosterone therapy may help improve glycemic (blood sugar) control, weight, and waist circumference in patients with T2D and low testosterone levels.

The authors report a large amount of data was missing between 30 and 82 weeks. The role of testosterone therapy in the benefits observed in this study warrants further investigation. Long-term clinical outcomes remain unclear.