Background: Men with T2DM have a high prevalence of hypogonadism.
Methods: In a registry of 823 men with hypogonadism, 324 men (39%) had T2DM. 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Changes over time between groups were compared by mixed effects model for repeated measures with random effect for intercept and fixed effects for time, group and their interaction. Changes were adjusted for age, weight, waist circumference, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between the two groups.
Results: Mean follow-up 7.9±2.4, age: 62.8±5.1 years. T-group: baseline HbA1c: 9.1±1.2%. HbA1c progressively decreased by 2.7±0.3% at 10 years. CTRL: baseline HbA1c: 7.8±0.7%. HbA1c increased by 2.9±0.3%. Estimated adjusted difference between groups: 5.6% (p<0.0001 for all). Fasting glucose (mmol/L) decreased in T-group by 1.7±0.2 and increased in CTRL by 1.6±0.2, difference between groups: 3.2 (p<0.0001 for all). Fasting insulin (µU/mL) decreased in T-group by 17.4±0.4 and increased in CTRL by 10.7±1.1, difference between groups: 28.1 (p<0.0001 for all). In the T-group, baseline HOMA-IR was 10.2±2.1. HOMA-IR progressively decreased by 6.9±0.2 at 10 years. CTRL: baseline HOMA-IR: 7.5±1.3. HOMA-IR increased by 7.6±0.5. Difference between groups: 14.5 (p<0.0001 for all). In the T-group, 92 men (60.5%) received insulin at baseline at a mean dose of 36.5±12.2 U/d and 66 in CTRL at a mean dose of 30.8±6.0 U/d. The dose requirement in the T-group declined by 17.7±1.0 U/d and increased in CTRL by 17.7±1.0 U/d. Difference between groups: 35.3 U/d (p<0.0001 for all). In CTRL, 20 patients were started on insulin during the observation time.
Conclusions: Long-term testosterone therapy with TU in men with hypogonadism and T2DM progressively improved glycemic control which worsened in untreated hypogonadal controls.
F. Saad: Employee; Self; Bayer AG. Stock/Shareholder; Self; AbbVie Inc., Amgen Inc., Bayer AG. K.S. Haider: Speaker's Bureau; Self; Bayer AG. A. Haider: Research Support; Self; Bayer AG. Speaker's Bureau; Self; Bayer AG.