Endocrine Abstracts

Background

Prevalence of hypogonadism has been reported as high as 50% in men with T2DM and/or obesity. ADA and AACE Guidelines recommend assessment of hypogonadism in men with T2DM and obesity.

Material and methods

In a registry of 865 men with hypogonadism, 361 men (41.7%) had T2DM. 183 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist circumference, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between the two groups. 12-year data are reported.

Results

Mean follow-up: 8.7 ± 3.1, baseline age: 60.7 ± 5.5 (T-group) and 63.0 ± 4.9 (CTRL) years. Glycaemic control at 12 years (mean values ± SE): HbA1c (%) progressively decreased by 3.7 ± 0.2 in the T-group and increased by 3.2 ± 0.2 in CTRL, estimated adjusted difference between groups: -6.9 [95% CI: -7.4;-6.4] (P < 0.0001 for all). Fasting glucose (mmol/l) decreased by 1.9 ± 0.1 (T-group) and increased by 1.8 ± 0.1 (CTRL), difference between groups: -3.6 [95% CI: -4.0;-3.3] (P < 0.0001 for all). HOMA-IR decreased by 8.0 ± 0.3 (T-group) and increased by 6.5 ± 0.4 (CTRL), difference between groups: -14.4 [95% CI: -15.5;-13.4] (P < 0.0001 for all). In CTRL, 22 patients were started on insulin during the observation period. Weight control at 12 years (mean values ± SE): 293 men (81.2%) were obese, 61 (16.9%) overweight and 7 (1.9%) had normal weight. Weight (kg) decreased by 22.5 ± 0.5 (T-group) and increased by 8.5 ± 0.5 (CTRL), difference between groups: -31.0 [95% CI: -32.7;-29.2] (P < 0.0001 for all). Weight loss (%) was 19.7 ± 0.4 in the T-group, weight gain 9.1 ± 0.4 in CTRL, difference between groups: -28.8 [95% CI: -30.2;-27.4] (P < 0.0001 for all). Waist circumference (cm) decreased by 13.6 ± 0.4 (T-group) and increased by 8.5 ± 0.4 (CTRL), difference between groups: -22.1 [95% CI: -23.4;-20.8] (P < 0.0001 for all). BMI (kg/m²) decreased by 7.4 ± 0.2 (T-group) and increased by 2.8 ± 0.2 (CTRL), difference between groups: -10.2 [95% CI: -10.8;-9.5] (P < 0.0001 for all). Since injections were administered in the office and documented, there was a 100% adherence to testosterone therapy.

Conclusion

Long-term testosterone therapy with TU in men with hypogonadism and T2DM progressively improved glycaemic as well as weight control which deteriorated in untreated men.