Background: Men with hypogonadism are at increased risk of MACE and mortality. Studies in men with T2DM show that testosterone therapy (TTh) reduces both MACE and mortality.

Methods: Of 361 men with hypogonadism and T2DM, 183 received testosterone undecanoate injections (TU) 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). MACE, mortality, and diabetic complications were recorded and compared between groups.

Results: Mean baseline age in the T-group and CTRL was 60.7±5.5 and 63.0±4.9 years. Mean follow-up in T-group vs. CTRL was 8.2 and 9.2 years. 70 patients (38.3%) in the T-group and 70 (39.3%) in CTRL had a history of cardiovascular disease (myocardial infarction MI, stroke, or coronary artery disease diagnosis) (p=0.8341). Baseline smoking prevalence was 41.0% (75 men) in the T-group and 38.2% (68 men) in CTRL (p=0.5161). The T-group had significantly worse baseline risk factor profile than CTRL: BMI (36.5±4.5 vs. 33.4±5.3 kg/m2), systolic blood pressure (163.0±13.5 vs. 145.6±14.6 mmHg), LDL (4.7±0.9 vs. 4.1±1.4 mmol/L), HbA1c 9.4±1.4 vs. 7.8±0.7% (p<0.0001 for all). Mortality: during the entire observation period, 15 patients (8.2%) died in the T-group vs. 61 (34.3%) in CTRL (p<0.0001). Major adverse cardiovascular events (MACE): in the T-group, there were no cases of MI or stroke. In CTRL, there were 56 cases of MI (31.5%) and 56 cases of stroke (31.5%). 35 patients (19.7%) suffered a MI and a stroke. Diabetic complications: in the T-group vs. CTRL, the incidence of retinopathy was 6 (3.3%) vs. 30 (16.9%) (p<0.0001), nephropathy 1 (0.01%) vs. 5 (2.8%) (p<0.05), polyneuropathy 11 (6.0%) vs. 97 (54.5%) (p<0.0001), diabetic foot syndrome 0 (0%) vs. 10.1% (p<0.0001).

Conclusions: Long-term treatment with TU in men with hypogonadism and T2DM significantly reduces mortality, compared to untreated controls.

Disclosure

K. S. Haider: Other Relationship; Self; Bayer AG. A. Haider: Other Relationship; Self; Bayer AG. F. Saad: Consultant; Self; Bayer AG, Stock/Shareholder; Self; AbbVie Inc., Bayer AG, Novo Nordisk.

Funding

Bayer AG

© 2021 by the American Diabetes Association
2021
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.