Testosterone therapy halts progression to T2D in men with hypogonadism

  • Diabetes Care

  • International Clinical Digest
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Takeaway

  • Testosterone therapy (TTh) prevented progression to overt type 2 diabetes (T2D) for 8 years in men with testosterone deficiency (hypogonadism) and prediabetes.

Why this matters                                                    

  • Men with hypogonadism are at increased risk for insulin resistance and T2D.

Study design

  • Real-life observational study of 316 men with prediabetes (HbA1c, 5.7%-6.4%) and total testosterone ≤12.1 nmol/L with hypogonadal symptoms.
  • 229 received parenteral testosterone undecanoate (e.g., Aveed) and 87 were untreated (controls). 
  • Metabolic and anthropometric parameters were measured twice yearly for 8 years.
  • Funding: Bayer AG.

Key results

  • At 8 years, HbA1c had decreased with TTh by 0.39 but increased by 0.63% points in controls (both P<.0001>
  • Proportions achieving HbA1c
  • 89.5% vs 0% achieved HbA1c
  • 40.2% of controls had progressed to overt T2D (HbA1c >6.5%).  
  • Weight changes were −8.8 kg with TTh vs +9.1 kg in controls (both P<.0001>
  • The TTh group had a 1.9 drop in triglyceride:high-density lipoprotein cholesterol ratio vs 2.1 gain in controls (P<.0001>
  • Mortality at 8 years was 7.4% TTh vs 16.1% in controls (P<.05>

Limitations

  • Not randomized.
  • TTh group was younger and had worse baseline metabolic status, worse symptoms, and lower baseline testosterone levels.

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