Testosterone Therapy for Diabetes Remission in Men

About one-third of adult men living with type 2 diabetes experience low testosterone levels. Testosterone is the hormone that plays a key role in masculine growth and development during puberty.

Diabetes has long been thought to be a contributing factor to low testosterone in men.

Driven by this connection, a group of researchers at the University of Buffalo studied the effects of testosterone hormone treatment on men living with type 2. To their surprise, this treatment not only resulted in better overall blood glucose control but actually led to diabetes remission in a large proportion of the subjects.

The Hypogonadism-Diabetes Connection

In 2004, Paresh Dandona and his team discovered that low testosterone levels — a condition known as male hypogonadism — commonly existed in adult males with diabetes. Six years later, their continued research uncovered that the same condition affects about one in four obese males who do not have diabetes.

The research team concluded that obesity and diabetes are both driving factors behind the development of hypogonadism.

Further investigation proved:

• Type 2 men with hypogonadism experienced a heightened inflammatory state and more severe insulin resistance compared to men with diabetes who don’t have hypogonadism.
• Testosterone hormone (TTh) increases insulin sensitivity and the expression of insulin receptors in adipose tissue.

Armed with this knowledge and previous study results showing that testosterone treatment had the power to halt the progression of diabetes in men with prediabetes, the researchers aimed to study the effects of testosterone treatment in type 2 men with hypogonadism in a real-world setting.

Promising Results of Testosterone Treatment

The study, which was published in Diabetes, Obesity and Metabolism, followed 356 hypogonadal male patients at a single urology clinic. 

All patients received the same education and support to care for their diabetes, but only half received testosterone treatment for their hypogonadism.

Over the course of the 11-year treatment, the researchers noted a marked improvement in glucose control within the testosterone treated group.

• Over one-third, (34.3%) of the subjects achieved diabetes remission
• 46.6% of subjects achieved normal glucose regulation with continued diabetes treatment
• 83.1% of subjects achieved an HbA1c of 6.5% or lower
• 90% of subjects achieved an HbA1c of 7% or lower

Additionally, the testosterone treated group saw fewer deaths, myocardial infarctions, strokes, and diabetic complications compared to the non-treated group.

• The testosterone subjects showed ‘significant progressive and sustained reductions in their body weight, fasting glucose, HbA1c, and fasting insulin over the treatment period.’
• Patients that did not receive testosterone treatment all saw increases in their HbA1c and fasting glucose over the study period and no instances of remission were found.

Considering that diabetes is the cause of hypogonadism in these individuals and not the other way around, these results are quite surprising.

A randomized, controlled trial is currently underway to confirm these remarkable results, and more trials are slated to begin soon.

If Dandona’s findings prove to be accurate, they could change not only how type 2 diabetes is treated in adult males, but could also greatly improve the prognosis for men living with the condition.

Read further about Paresh Dandona’s research in Leveraging T2D Drugs to improve T1D Therapy.