Treatment of hypogonadism with testosterone in patients with type 2 diabetes
mellitus.
Author(s): Gopal RA, Bothra N, Acharya SV, Ganesh HK, Bandgar TR, Menon PS, Shah NS.
Affiliation(s): Department of Endocrinology, Seth Gordhandas Sunderdas Medical College and King
Edward Memorial Hospital, Mumbai, India. drrajugopal@gmail.com
Publication date & source: 2010, Endocr Pract. , 16(4):570-6
OBJECTIVE: To investigate the effect of testosterone treatment on insulin
resistance, glycemic control, and dyslipidemia in Asian Indian men with type 2
diabetes mellitus (T2DM) and hypogonadism.
METHODS: We conducted a double-blind, placebo-controlled, crossover study in 22
men, 25 to 50 years old, with T2DM and hypogonadism. Patients were treated with
intramuscularly administered testosterone (200 mg every 15 days) or placebo for 3
months in random order, followed by a washout period of 1 month before the
alternative treatment phase. The primary outcomes were changes in fasting insulin
sensitivity (as measured by homeostasis model assessment [HOMA] in those patients
not receiving insulin), fasting blood glucose, and hemoglobin A1c. The secondary
outcomes were changes in fasting lipids, blood pressure, body mass index, waist
circumference, waist-to-hip ratio, and androgen deficiency symptoms. Statistical
analysis was performed on the delta values, with the treatment effect of placebo
compared with the effect of testosterone.
RESULTS: Treatment with testosterone did not significantly influence insulin
resistance measured by the HOMA index (mean treatment effect, 1.67 +/- 4.29;
confidence interval, -6.91 to 10.25; P>.05). Mean change in hemoglobin A1c (%)
(-1.75 +/- 5.35; -12.46 to 8.95) and fasting blood glucose (mg/dL) (20.20 +/-
67.87; -115.54 to 155.94) also did not reach statistical significance.
Testosterone treatment did not affect fasting lipids, blood pressure, and
anthropometric determinations significantly.
CONCLUSION: In this study, testosterone treatment showed a neutral effect on
insulin resistance and glycemic control and failed to improve dyslipidemia,
control blood pressure, or reduce visceral fat significantly in Asian Indian men
with T2DM and hypogonadism.
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