820-P: Testosterone Treatment Improves Glycemic Control and Leads to Remission in 56.8% of Patients with Hypogonadism and Type 2 Diabetes (T2DM) : Update of Real-World Data from a Registry Study

Background: Prevalence of hypogonadism is as high as 50% in men with T2DM. ADA Guidelines recommend measuring testosterone in men with T2DM.

Methods: In a registry of 883 men with hypogonadism, 370 men (41.9%) have T2DM. 190 received TU 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . All patients received standard diabetes care including lifestyle courses at a diabetes center. Remission was defined as discontinuation of diabetes drugs and HbA1c <6.5% for the remaining observation time. Means and standard deviations of absolute measures over 13 years of treatment are reported.

Results: Mean follow-up 9.3±3.2, baseline age: 61.0±5.3 (T-group) and 63.0±4.9 (CTRL) years.

HbA1c decreased from 9.5±1.4% to 5.5±1.2% (79.8±15.5 to 36.6±1.9 mmol/mol) in the T-group and increased from 7.8±0.7% to 10.5±1.2% (61.8±7.7 to 91.7±13.3 mmol/mol) in CTRL (p<0.00for both) .

Fasting glucose (mmol/L) decreased from 7.9±1.3 to 5.4±0.1 in the T-group and increased from 6.4±0.8 to 8.2±1.3 in CTRL (p<0.00for both) .

HOMA-IR decreased from 10.2±2.1 to 1.5±0.3 in the T-group and increased from 7.3±1.3 to 14.8±2.5 in CTRL (p<0.00for both) .

In the T-group, 89 men (46.8%) received insulin at baseline at a mean dose of 38.0±13.3 U/d. Dose requirement declined from 38.0±13.3 to 4.1±5.7 during the observation period. In CTRL, 71 men (39.4%) received insulin at baseline at a mean dose of 31.2±6.1 U/d. Dose requirement increased from 31.2±6.1 to 44.5±5.6 (p<0.00for both) .

In the T-group, 1patients (56.8%) went into remission. The median time to remission was 87 months.

Conclusions: Long-term testosterone therapy with TU in men with hypogonadism and T2DM progressively improved glycemic control. More than half of men achieved remission. Glycemic control deteriorated in untreated men.