Background: In the 2018 ADA Standards of Medical Care in Diabetes checking testosterone in men with diabetes was added as new recommendation.

Methods: A registry of hypogonadal men (testosterone ≤12.1 nmol/L) was initiated in 2004 in a urological setting. By 2018, 324 of 823 patients (39%) had T2DM diagnosed and treated in a diabetes center. 152 of these men received testosterone undecanoate (TU) injections 1000 mg/12 weeks (T-group) following an initial 6-week interval. Anthropometric and metabolic parameters were measured at least twice a year and fasting insulin obtained from the diabetes center to calculate HOMA-IR.

Results: Mean follow-up was 7.9, maximum 12 years. 51 patients (33.6%) were in remission at the last measurement. Their average baseline age was 61±4.11 years. HbA1c dropped from 8.6±1.01% at baseline to 5.45±0.18%, fasting glucose from 7.8±1.2 mmol/L to 5.4±0.09 mmol/L. HOMA-IR dropped from 9.76±2.74 to 1.98±0.54. Triglycerides decreased from 3.41±0.57 to 2.18±0.11 mmol/L. Anthropometric parameters: Body weight declined progressively from 112.9±13.2 to 90.2±7.4 kg, waist circumference from 110.7±7.6 to 97.8±4.6 cm. All patients had been on oral antidiabetic medication (metformin) at baseline. 17 patients were on insulin at an average dose of 25.3±5.9 units per day. The average observation time was 124.1±22.7 months (10.3±1.9 years). The average time to discontinuation of diabetes medication was 107.2 months (8.9 years). Medication adherence to TU was 100% as all injections were administered in the urology office and documented.

Discussion: The registry was not designed to study the effects of testosterone on T2DM. Remission of T2DM has not been described in the literature and was unexpected.

Conclusions: Long-term testosterone treatment in hypogonadal men may result in remission of T2DM.


K.S. Haider: Speaker's Bureau; Self; Bayer AG. A. Haider: Research Support; Self; Bayer AG. Speaker's Bureau; Self; Bayer AG. F. Saad: Employee; Self; Bayer AG. Stock/Shareholder; Self; AbbVie Inc., Amgen Inc., Bayer AG.


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