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Ronald Swerdloff Part 2, Testosterone Replacement And Diabetes

In part 2 of this Exclusive Interview, Dr. Ronald Swerdloff talks with Diabetes in Control Publisher Steve Freed during the ADA 2017 Scientific Sessions in San Diego, CA about testosterone replacement and diabetes, and methods to lower testosterone.

Ronald Swerdloff, MD is a professor of medicine at David Geffen School of Medicine at UCLA, the chief of division of endocrinology and metabolism at the Harbor UCLA Medical Center, and the senior investigator at the LA Biomedical Research Institute.

Transcript of this video segment:

Steve: What are some of the things that can be used to lower the testosterone levels?

Dr. Swerdloff:  There is a number of things that have been used to lower testosterone. There are substances which act on the pituitary gland and lower parts of the brain that turn off the productions of the signals to the testes.  Those became very popular in treatment of patients with advanced prostate cancer.  However, it resulted in a large number of complications and the patients haven’t done very well.  So, its beginning to fall out of favor.

Steve: When you have low testosterone and adding testosterone replacement, does that possibly increase the risk for diabetes?

Dr. Swerdloff:  Just the opposite, I think. The issue is that people with diabetes have low testosterone and people with low testosterone have a greater chance of having diabetes. Now, the association is clear, but causality is less so. It is not clear whether or not this worsening of the testosterone-lowering effect in diabetes is not just an effect from chronic illness, because many chronic illnesses lower testosterone levels. We don’t know about specificity of this, but we do know that in diabetes there is a significant percentage of the individuals who have low testosterone.

Steve: When do you add the testosterone replacement for patients with diabetes?

Dr. Swerdloff:  This is a very interesting and controversial issue. Because there are people, based upon registry studies, that have been strong advocates for treatment with testosterone to improve blood sugar control. However, meta-analyses have failed to confirm that. So, we need to have more data with double-blinded, placebo-controlled studies to truly know the answer whether or not the treatment with testosterone will enhance blood sugar control.

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