In part 1 of this Exclusive Interview, Michael Irwig talks with Diabetes in Control Publisher Steve Freed about low testosterone and diabetes, & why men with diabetes typically have lower testosterone than men without diabetes.
Michael Irwig, MD, FACE, is a general endocrinologist at George Washington University in Washington, D.C.
Transcript of this video segment:
Freed: This is Steve Freed with Diabetes in Control and we’re here at AACE 2018 in Boston. And we’re here with a very special guest, Dr. Michael Irwig. And maybe we can start off with, you could give us a little background of what you do and the type of practice.
Irwig: So, I’m a General Endocrinologist. I practice at George Washington University in Washington DC at the Medical Faculty Associates. And I see patients of all types, a lot of diabetes, a lot of thyroid. I also do a lot with testosterone and androgens, and with transgender.
Freed: And you did a presentation or you’re going to do a presentation. And what’s the title of that presentation?
Irwig: So, the presentation that was in the pre-congress was Treatment Options for Male Hypogonadism, which is the treatment of low testosterone.
Freed: Okay. Maybe we can start off with why do so many men with diabetes have lower testosterone levels with diabetes?
Irwig: So, men are getting their testosterone levels checked a lot more frequently than they did decades ago. And so, the more people you check, the more people who you’re going to have with low levels. Now, men with type 2 diabetes often have comorbid overweight or obesity and that can affect the reproductive access. So, when you’re overweight or when you’re obese that can affect sex hormone-binding globulin which is a protein that binds to testosterone. And you can have lower levels of this protein, so that when you measure the testosterone it appears lower than it would otherwise. So, if you compare normal weight man to obese man, obese man will often have 25% lower total testosterone levels. Now, one other mechanism is that in fat tissue testosterone gets converted into estrogen. And then that estrogen gives a feedback to the brain to kind of slow down the reproductive system. So, often men who are obese will have low total but also low free testosterone as well.