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Multiple Benefits of Long-Term Testosterone Replacement Therapy for Diabetes Patients

Testosterone replacement therapy may be beneficial for metabolic syndrome components…. 

According to a recent study, testosterone replacement therapy may have benefits on weight and waist size in obese, hypogonadal men.

In this prospective, observational study, hypogonadal men with obesity were selected to receive parenteral testosterone undecanoate. Study participants received intramuscular injections of 1,000 mg testosterone undecanoate on day 1, at week 6, and every 3 months thereafter.

After 5 years of treatment, the average weight of participants dropped from 104.2 kg at baseline to 92.5 kg. 96.3% of participants lost weight with 80.2% having lost ≥ 5 kg, 51.2% having lost ≥10 kg, 31.5% having lost ≥ 15 kg, and 14.2% having lost ≥ 20 kg.

Statistically significant decrease in waist circumference was seen in addition to improvements in both lipid profiles and blood pressure. The waist circumference of study participants decreased from a baseline average of 108.6 cm down to 99.0 cm. Average total cholesterol dropped from 264 to 212 mg/dL. The average low-density lipoprotein cholesterol (LDL-C) dropped from162.3 mg/dL to 126.4 mg/dL; and the average triglyceride level dropped from 261mg/dL to 199 mg/dL. Further, HDL-C increased from 40.1 mg/dL up to 55.6 mg/dL.

Average systolic and diastolic blood pressure decreased from 140 to 122.3 mmHg and 81.6 to 77.6 mmHg, respectively. In addition, mean fasting glucose levels decreased from 112.7 to 99.0 mg/dL and mean glycated hemoglobin (HbA1c) values decreased from 6.7% to 5.6%.

Overall, individuals in this study experienced an average drop in their BMI from 33.1 down to 29.4.

Practice Pearls:
  • A statistically significant drop in body weight and waist circumference was seen in participants using testosterone undecanoate for testosterone replace therapy
  • Testosterone replacement therapy may have additional beneficial effects on glucose, lipids, and blood pressure, in hypogonadal obese men
  • Additional studies are needed evaluating risks verses benefits in subpopulations of patients

Yassin DJ, Doros G, Hammerer PG, Yassin AA. Long-Term Testosterone Treatment in Elderly Men with Hypogonadism and Erectile Dysfunction Reduces Obesity Parameters and Improves Metabolic Syndrome and Health-Related Quality of Life. J Sex Med. 2014.