Endocrine Abstracts

Approximately 25–40% of men with type 2 diabetes suffer from hypogonadism, mostly mixed type. Despite a clear association between diabetes and hypogonadism, the exact mechanism is not completely understood; insulin resistance, elevated oestradiol and inflammatory mediators may all have key roles. Studies so far, are conflicting on the benefits of testosterone on metabolic parameters in these men. Hughes et al and meta-analysis by Cai et al showed a significant improvement but others with conflicting results.

The aim of this audit was to examine the effects of testosterone treatment on metabolic and QOL parameters in routine clinical practice. We have retrospectively reviewed 23 diabetic patients on testosterone replacement with a minimum follow up of 6 months, for its impact on glycaemic control and lipid profile and quality of life.

Results are presented as mean±S.D. Mean age 59 years ±10. With treatment total Testosterone rose from 7.87±4.5 nmol/l to 17±3 (P=0.0002). This was associated with fall in HbA1C in % (9.7±2 to 7.9±1.7, P=0.01), total cholesterol in mmol/l (4.1±1 to 3.8±0.98, P=0.01) and LDL in mmol/l (2.3±0.9 to 2±0.85, P=0.02) at 3–6 months. Except in 2 patients, the statin dose remained unchanged. Full details on changes to diabetes treatment were not available. Energy, drive and libido increased significantly from 5.1±1.8 to 7.5±1.3, 4.8±2.4 to 7.7±1.9, 5.3±1.7 to 8±1.3 respectively out of score of 10 (P=0.001).

This audit demonstrates that in routine clinical practice testosterone can be an effective adjunct in hypogonadal diabetic men and it also suggests that effect on HbA1c may be greater than previously reported. There are lots of limitations to this small retrospective audit but the findings are in line with reported literature.