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Testosterone Therapy and Diabetes

Testosterone Therapy and Diabetes

April 1, 2019

Testosterone Replacement Therapy and DiabetesAccording to the latest numbers, 1 in 7 Americans (30 million people) have some form of diabetes – and they do not even know it! Of the 14 percent of adults in the US with diabetes, only 10 percent know they have it. Part of the problem may be that diabetes risk increases with age, as does conditions such as low testosterone. Many people walk around with these conditions and attribute their symptoms to natural aging. Warning: diabetes and low testosterone are not physical aspects of aging, and if left undiagnosed, they could lead to increased risks of heart attacks, strokes, and other potentially dangerous health issues. That is why we bring you this up-to-date report on the latest information about testosterone therapy and diabetes.

Diabetes is also more prevalent in men than women with a 16 percent incidence in males and 12 percent in females. Here are some other startling statistics:

  • 21 percent of obese adults have diabetes
  • 12 percent of overweight adults have diabetes
  • 6 percent of normal or underweight adults have diabetes

The answer is apparent – weight gain is directly related to diabetes risk.

As we further look at testosterone replacement therapy and diabetes, we find that as many as one in 4 men over the age of thirty may have low testosterone levels. Those with clinical Low T symptoms may be one in every twenty men. The percentage increases with age. By 2025, it is predicted that 6.5 million men in the US between the ages of 30 and 79 may have Low T symptoms. That does not even consider the percentage of women with low testosterone.

Type 2 diabetes is most common in adults. People with type 2 diabetes often receive a diagnosis during childhood. For that reason, most of our discussion today will focus on testosterone therapy and type 2 diabetes.

Here are some other staggering statistics:

  • Low testosterone risk in men with diabetes is 2.1 times higher than those without
  • Obese men have a 2.4 times greater risk of having low testosterone
  • Men with high blood pressure have a 1.8 times higher chance of Low T

What comes first: low testosterone, obesity, or diabetes?

We do not always know the answer to that. Science has not yet determined if low testosterone causes diabetes or if diabetes contributes to low testosterone. Here is what we know for certain:

  • Low testosterone impacts metabolic functions, causing the body to gain weight rather than use food for energy
  • People who are overweight produce more aromatase in their fat – the enzyme that lowers testosterone levels by converting free testosterone into estradiol (estrogen)
  • Estrogen tells the body to increase fat storage

The connection between low testosterone, obesity, and diabetes is clear.

How Does Testosterone Impact Glucose Levels and Insulin Sensitivity?

Testosterone helps increase the sensitivity of the body’s tissues and cell’s to insulin, allowing them to take in circulating blood sugar (glucose). When you have low levels of testosterone, you decrease the cell’s sensitivity to the effects of insulin. Instead of using that insulin to improve glucose uptake, insulin and glucose continue to circulate in the bloodstream. The cells do not get the fuel they require.

When we look at testosterone therapy and diabetes, we find that people with Low T who receive treatment improve their insulin sensitivity. That allows for the removal of insulin and blood sugar from the bloodstream. Otherwise, if the cells are insulin resistant, the pancreas will continue to saturate the blood supply with more insulin to try and get the glucose out of the bloodstream.

In an endocrinology report published in The Aging Male from June of 2018 about testosterone therapy, diabetes type 2, and obesity, testosterone replacement therapy (TRT) significantly decreases insulin resistance and fasting glucose levels while reversing endothelial dysfunction. The study participants had hypogonadism, comorbid obesity, and type 2 diabetes.

Following one year of treatment, here are the results:

  • Significant improvement in flow-mediated dilation rates following TRT over a placebo
  • Reduced fasting plasma glucose levels in only the testosterone-treated group
  • Significant decrease in plasma insulin levels and insulin resistance for those receiving TRT
  • Better reduction in intima media thickness than placebo group

Researchers reported both placebo and TRT groups reduced overall waist circumference and body mass index. The change in the placebo group could be due to a general positive effect of study participation.

Testosterone has a direct impact on cellular sensitivity to insulin and glucose uptake.

Does Low Testosterone Contribute to Type 2 Diabetes?

As we go back to the question of which came first regarding low testosterone causing diabetes – the jury is still out. Contribution-wise – each one impacts the other.

We know that low testosterone reduces cellular insulin sensitivity. That is a given. By nature, that would suggest why we see such improvements from testosterone therapy and diabetes symptoms. TRT helps improve the cell’s ability to take in glucose. Anything that helps remove insulin and glucose from the bloodstream is vital to a person’s overall health.

Men with the lowest levels of free testosterone have the greatest risks of having diabetes. Of those with higher testosterone concentrations, they had a significantly lower risk of developing type 2 diabetes. In one study of men with chronic kidney disease who receive dialysis, 90 percent were also diagnosed with low testosterone.

These numbers cannot and should not be overlooked. For the men in the study who received testosterone replacement therapy, and diabetes type 2 was also a concern, there was a significant reduction in body fat equivalent to an increase in muscle mass following 24 weeks of treatment. Those who received TRT rather than a placebo saw a 32% increase in glucose uptake response to insulin. Fasting glucose levels also decreased 12 milligrams per deciliter.

Low testosterone has a direct impact on insulin sensitivity and cellular glucose uptake which could lead to type 2 diabetes.

How Do You Manage Low Testosterone and Diabetes?

For people with diabetes, life can seem like a never-ending cycle of testing one’s blood and taking insulin or other medications. Some treatments work to decrease the liver’s production of glucose – allowing increased cell sensitivity to insulin. Other medications tell the pancreas to produce more insulin. There are also medications that help improve insulin functions as well as those that slow food digestion. What we want to look at right now is testosterone replacement therapy and type 2 diabetes.

In one report from 2018, researchers found that some men in a study went into complete diabetes remission following treatment for hypogonadism. The men were on long-term testosterone therapy, and diabetes blood tests were conducted twice a year. Researchers followed the participants for an average of 6.9 years, with a maximum study examination of 11 years. The average participant age was 60 years.

Here are the results of that study:

  • 12% (16 men) went into diabetes remission
  • HbA1c declined from 8.3% at baseline to 5.7%
  • Fasting insulin and glucose levels declined
  • Triglycerides dropped from a baseline of 3.2 mmol/L to 2.2 mmol/L
  • Body weight and waist circumference decreased
  • Diabetes medications discontinued at an average of 74.8 months
  • The control group that did not receive TRT had a threefold increase in mortality compared to the treated patients – typically due to cardiovascular risk factors

Not only do studies show testosterone therapy to reduce the symptoms of diabetes, but treatment with TRT also improves cardiovascular risk factors.

Benefits of Testosterone Therapy for Diabetes

By now, you probably realize the importance of getting tested for low testosterone if you have diabetes. The use of testosterone therapy for diabetes control and even remission may help you decrease the significant risk factors associated with these conditions. Since both low testosterone and diabetes risks increase with weight gain, you can use TRT to help you lose abdominal adiposity and improve lean muscle mass.

When you receive testosterone therapy treatment, diabetes symptoms naturally improve as the cells become more sensitive to the effects of insulin. The tissues pull in glucose from the blood, providing energy to the body.

In addition, the benefits of TRT for heart health can significantly improve cardiovascular disease symptoms and risks.

For additional information about testosterone therapy and diabetes, please contact HGH Doctor hormone clinic for a free consultation.

Testosterone therapy has benefits for reducing the symptoms of diabetes, stimulating weight loss, and improving cardiovascular health.

  1. International Society for Sexual Medicine
  2. Renal&Urology News
    Testosterone level and risk of type 2 diabetes in men: a systematic review and meta-analysis
    Qiu-ming Yao,1 Bin Wang,1 Xiao-Fei An,1 Jin-an Zhang, corresponding author, and Liumei Dingcorresponding author.
  3. Low Testosterone in Men with Type 2 Diabetes: Significance and Treatment Mathis Grossmann The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 8, 1 August 2011, Pages 2341–2353.
  4. Age Management Boston
  5. Mantality Health
  6. Testosterone Therapy in Patients with Type 2 Diabetes Allan S. Brett, MD reviewing Gianatti EJ et al. J Clin Endocrinol Metab 2014 Oct.
  7. Testosterone levels in men with type 2 diabetes mellitus Satish Chaudhary, Madan Kaushik, V. M. S. Jaswal, Rajeev Raina, Roshan Thakur, Manish Kumar Thakur, Ritin Sharma.