Issue: June 2011
June 01, 2011
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Testosterone replacement may improve death rate in testosterone-deficient men with diabetes

Issue: June 2011
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Society for Endocrinology BES 2011

A new study of men with type 2 diabetes showed that those with low testosterone levels may die sooner unless they are given testosterone replacement therapy.

Low testosterone levels placed men with diabetes at an increased risk for death (P=.001), according to data presented at the Society for Endocrinology BES 2011 meeting. Thirty-six of 182 men with diabetes and untreated low testosterone died during the 6-year study compared with 31 of 338 men with normal testosterone levels (20% vs. 9%). Further, only five of 58 men with diabetes who were given testosterone replacement therapy died during the study (8.6%), meaning that they showed better survival compared with the non-treated group (P=.049).

“This is potentially a very exciting finding,” T. Hugh Jones, MD, of the Barnsley Hospital NHS Foundation Trust and the University of Sheffield, United Kingdom, said in a press release. “While we have shown that low testosterone levels can put diabetic men at greater risk of dying, we have also demonstrated for the first time the potential benefit that testosterone replacement therapy holds for this group of patients.”

The 6-year study included 587 men with type 2 diabetes. Participants were divided into three groups:

  • Those with normal testosterone levels (>10.4 nmol/L; n=338).
  • Those with low testosterone levels (<10.4 nmol/L) not treated with testosterone replacement therapy (n=182).
  • Those with low testosterone levels treated with testosterone replacement therapy for 2 years or more (n=58).

The researchers said this is the first study to show that testosterone replacement therapy can improve survival in testosterone-deficient men with type 2 diabetes.

“It is well known that men with type 2 diabetes often have low testosterone levels, so it is important that we investigate the health implications of this. We now need to carry out a larger clinical trial to confirm these preliminary findings. If confirmed, then many deaths could be prevented every year,” Jones said in the release.

In a second study presented at the meeting, Jones and colleagues found that low testosterone and severity of erectile dysfunction are independently associated with a reduced health-related quality of life in men with type 2 diabetes.

Of the 356 men with type 2 diabetes who were questioned about their health-related quality of life, scores decreased as testosterone levels decreased (P=.044). When the researchers assessed 126 men for erectile dysfunction, health-related quality of life decreased in physical functioning (P=.003), social functioning (P=.022), vitality (P=.025) and pain (P=.012) as the severity of erectile dysfunction increased.

“This finding supports previous evidence suggesting that erectile dysfunction is a marker of ill health,” Jones said in the release. “Our next step is to assess whether offering testosterone replacement therapy to diabetic men with testosterone deficiency and erectile dysfunction may help to improve their health-related quality of life.”

Disclosure: Dr. Jones reports no relevant financial disclosures.

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