Endocrine Abstracts

It is known that the presence of type 2 diabetes mellitus (T2DM) deteriorates the psychological status of patients, but its combination with a deficiency of testosterone (T) in men is not well studied. The aim of this work was to study the effect of T replacement therapy (TRT) on the levels of anxiety, depression, symptoms of androgen deficiency, diabetes and quality of life in men with T2DM and functional hypogonadism.

Materials and methods: We examined 90 men with T2DM and a T deficiency (mean age 51.5 ± 6.3 years), which were divided into 2 groups: 1–40 patients who received TRT using transdermal T-gel (Androgel 50 mg/day) for 9 months and standard hypoglycemic therapy and 2–50 patients who were not assigned to TRT and received just antidiabetic drugs. Patients underwent clinical and psychological examinations, such as questionnaires HADS, aging male symptoms (AMS), symptoms of diabetes (DSC) and quality of life (SF-36). Statistical analysis of the data was carried out using the Wilcoxon test for time-depended parameters and Mann-Whitney U test for two independent groups using the Statistica software package (StatSoft 10).

Results: Analysis of the AMS questionnaire in men who received TRT revealed a significant (P = 0.003) decrease in the total score of androgen deficiency symptoms from 38.5 [35; 46] to 30 [24; 39]. The diabetic symptoms according to DSC questionnaire also were decreased: the psychological scale by 0.75 ± 0.04 points (P = 0.04), manifestations of hyperglycemia by 0.5 ± 0.09 points (P = 0.04) and neuropathy scale by 0.6 ± 0.03 (P = 0.02) points. Moreover, the anxiety levels were significant decreased 1.8-fold (P < 0.001) and depression level – 2-fold (P = 0.001) in the 1st group. The quality of life according to SF-36 questionnaire were significant improved (P < 0.01) in the physical functioning, general health, vitality, social functioning, and role-emotional scales compared to baseline in patients receiving TRT. In the control group no significant changes occurred.

Conclusion: The appointment of TRT in men with T2DM not only reduces the symptoms of androgen deficiency and diabetes, but also significantly decreases levels of anxiety and depression, which improve the quality of life in these patients.

Acknowledgements: Supported by Russian Science Foundation, grant No. 14-25-00052.