Testosterone therapy may lower HbA1c for men with type 2 diabetes, hypogonadism
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Key takeaways:
- Men with type 2 diabetes and hypogonadism receiving testosterone therapy had reductions in HbA1c at 3 months, 1 year and 2 years.
- More data are needed to assess cardiometabolic effects of testosterone therapy.
Testosterone therapy may reduce HbA1c for men with type 2 diabetes and hypogonadism, according to a presenter at the European Association for the Study of Diabetes annual meeting.
In an analysis of real-world data from an ongoing clinical audit, men who received testosterone therapy had a decrease in HbA1c at 3, 12 and 24 months compared with baseline.
“This study so far confirms that testosterone replacement does benefit HbA1c over time,” T. Hugh Jones, MD, consultant physician and endocrinologist at Barnsley Hospital, honorary professor of andrology at the University of Sheffield and honorary consultant endocrinologist at Royal Hallamshire Hospital in Sheffield, U.K. told Healio. “This audit supports the use of testosterone replacement in hypogonadism men with type 2 diabetes. Clearly more data will come with the length of follow-up and more patients in the audit.”
The data presented by Jones and colleagues were an early analysis of an audit that is being conducted by the Association of British Clinical Diabetologists at multiple centers to assess the clinical effects and monitoring of testosterone therapy for men with type 2 diabetes and hypogonadism. Prospective and retrospective data from normal clinical practice were provided by 34 centers in eight countries. HbA1c was assessed at baseline and at 3, 12 and 24 months. Of the study participants, 193 were receiving metformin, 99 were receiving insulin, five were receiving a GLP-1 receptor agonist and one was receiving an SGLT1 inhibitor.
There were 80 paired cohorts of men assessed at 3 months. In this group, HbA1c declined from 8.7% at baseline to 8.2% at 3 months (P < .001). Among 121 paired cohorts assessed at 12 months, HbA1c dropped from 8.7% at baseline to 7.8% at follow-up (P < .001). Of 104 paired cohorts assessed at 24 months, HbA1c declined from 8.7% at baseline to 7.3% at 24 months (P < .001).
“Testosterone has different actions on glucose and fat metabolism,” Jones said. “Some actions are evident over a few weeks, but the effect on reducing fat mass and increasing muscle mass may continue for several months and years. Registry studies have reported this effect.”
Jones said the audit data are important for analyzing the effects of testosterone therapy on type 2 diabetes as long-term randomized controlled trials are unlikely to be conducted due to their length and cost. He said evidence on the effects of testosterone therapy will become stronger as more centers join the audit and more data become available.
“It is important to recognize this is early data,” Jones said. “We would like to advertise the audit to encourage new doctors from any specialty that treats testosterone deficiency in type 2 diabetes.”
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Jones TH, et al. Abstract 704. Presented at: European Association for the Study of Diabetes Annual Meeting; Oct. 2-6, 2023; Hamburg, Germany (hybrid meeting).
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