Insulin sensitivity increases with testosterone therapy in men with type 2 diabetes
Testosterone treatment increased insulin sensitivity and lean body mass and decreased subcutaneous fat in men with type 2 diabetes and hypogonadotropic hypogonadism, according to study findings.
“This is the first definitive evidence that testosterone is an insulin sensitizer and, hence, a metabolic hormone,” Paresh Dandona, MD, PhD, an Endocrine Today Editorial Board member and chief of endocrinology, diabetes and metabolism in the department of medicine in the Jacobs School of Medicine and Biomedical Sciences at the State University of New York at Buffalo, said in a press release.
Dandona and colleagues evaluated 94 men with type 2 diabetes to determine the effect of testosterone replacement on insulin resistance.
“We hypothesized that testosterone may be an anti-inflammatory and insulin-sensitizing agent since it has been known for some time that testosterone reduces adiposity and increases skeletal muscle,” Dandona said in the release. “Our previous work has shown that obesity is associated with oxidative stress and inflammation, and inflammatory mediators are known to interfere with insulin signaling.”
Fifty participants were eugonadal (controls), and 44 had hypogonadotropic hypogonadism. Participants with hypogonadotropic hypogonadism were randomly assigned to intramuscular testosterone (250 mg) or placebo every 2 weeks for 24 weeks. Eugonadal men had higher subcutaneous and visceral fat mass compared with men with hypogonadism, whereas men with hypogonadism had 36% lower glucose infusion rate.
In men with hypogonadism, glucose infusion rate increased by 32% after 24 weeks with testosterone therapy compared with no change after placebo (P = .03). After testosterone treatment, the expression of insulin-signaling genes were significantly upregulated in adipose tissue. Concentrations of free fatty acids, C-reactive protein, interleukin-1 beta, tumor necrosis factor-alpha and leptin significantly fell after testosterone treatment (P < .05 for all).
“Testosterone treatment for men, where indicated, will improve sexual function and increase skeletal muscle strength and bone density,” Dandona said in the release. – by Amber Cox
Disclosure : Dandona reports receiving research support, honorarium and/or grants from Abbott Laboratories, Allergan, Bristol-Myers Squibb, Conjuchem, the CDC, the Citrus Industry of Florida, Dannipon Pharmaceuticals, Eli Lilly, GlaxoSmithKline, Merck, the Millard Fillmore Foundation, Mitsubishi, the NIH, Novartis, Novo Nordisk, the Oishei Foundation, Proctor & Gamble Pharmaceuticals, Quigley Pharma, Sankyo Pharmaceuticals North America, Sanofi, Solvay Pharmaceuticals, Takeda Pharmaceuticals, ToleRx, Transition Therapeutics and the William G. McGowan Charitable Fund. Please see the full study for a list of all other authors’ relevant financial disclosures.