Issue 18, April 2010
2. Male sex hormone to be useful in diabetes treatment

    News from the British Endocrine Society meeting show that giving testosterone can improve T2 diabetes. Low testosterone level is a known risk factor for development of  T2 diabetes. In addition erectile dysfunction is a common problem in men with diabetes. A study published last year by Professor Hugh Jones, an endocrinologist at Barnsley Hospital show that around 40 per cent of men with Type 2 diabetes have low testosterone levels.

    The investigators recruited 220 patients with a serum testosterone level below 11 nmol/L or calculated free serum testosterone less than 255 pmol/L, and with at least two symptoms of testosterone deficiency and no replacement therapy within the previous six months. The participants also had to meet International Diabetes Federation criteria for metabolic syndrome and/or type 2 diabetes.

    They were randomized to receive either a placebo gel or the testosterone product (Tostran) at 60 mg/day. Serum levels were monitored and doses were adjusted to meet a target of at least 17 nmil/L. The treatment lasted one year. Importantly, no changes in pre-existing glucose- or lipid-lowering medications were permitted during the first six months of treatment unless absolutely necessary, Jones said.

    The primary study outcome was the change in insulin resistance as measured by HOMA-IR values. Secondary endpoints in the study included changes in glycated hemoglobin, blood lipids, body composition, and sexual function.

    Compared with placebo, the group receiving the active treatment had declines in HOMA-IR of 0.85 points on an intent-to-treat basis (P=0.018) at six months and 0.84 points (P=0.06) at 12 months, Jones reported. That reduction, approximately 15%, is less than what is typically seen with thiazolidinedione drugs (around 25%)

    Though the trial was marred by high drop out, these results show that testosterone replacement can help to improve some symptoms of T2 diabetes in diabetic patients with low testosterone level.

 
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