Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes
Abstract
Objective : Low levels of testosterone in men have been shown to be associated with type 2 diabetes, visceral adiposity, dyslipidaemia and metabolic syndrome. We investigated the effect of testosterone treatment on insulin resistance and glycaemic control in hypogonadal men with type 2 diabetes. Design : This was a double-blind placebo-controlled crossover study in 24 hypogonadal men (10 treated with insulin) over the age of 30 years with type 2 diabetes. Methods : Patients were treated with i.m. testosterone 200 mg every 2 weeks or placebo for 3 months in random order, followed by a washout period of 1 month before the alternate treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostatic model index (HOMA) in those not on insulin), fasting blood glucose and glycated haemoglobin. The secondary outcomes were changes in body composition, fasting lipids and blood pressure. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared against the treatment effect of testosterone. Results : Testosterone therapy reduced the HOMA index (−1.73 ± 0.67, P = 0.02, n = 14), indicating an improved fasting insulin sensitivity. Glycated haemoglobin was also reduced (−0.37 ± 0.17%, P = 0.03), as was the fasting blood glucose (−1.58 ± 0.68 mmol/l, P = 0.03). Testosterone treatment resulted in a reduction in visceral adiposity as assessed by waist circumference (−1.63 ± 0.71 cm, P = 0.03) and waist/hip ratio (−0.03 ± 0.01, P = 0.01). Total cholesterol decreased with testosterone therapy (−0.4 ± 0.17 mmol/l, P = 0.03) but no effect on blood pressure was observed. Conclusions : Testosterone replacement therapy reduces insulin resistance and improves glycaemic control in hypogonadal men with type 2 diabetes. Improvements in glycaemic control, insulin resistance, cholesterol and visceral adiposity together represent an overall reduction in cardiovascular risk.
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Effects of testosterone on glycemic control become evident only after 3-12 months.
“Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3–12 months.”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
Testosterone treatment decreases waist hip ratio after 3 months or after 6 months and 30 weeks.
“and a decrease in the waist hip ratio after 3 months (31, 36) or after 6 months and 30 weeks respectively (17).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
Testosterone treatment decreases trunk fat or waist circumference after 3 months, with continuous decline over 24 months.
“A decrease in trunk fat or waist circumference was noted in a number of studies after 3 months (35, 36) with continuous decline over 24 months (32)”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
Serum glucose is reduced after 3 months of testosterone administration in men with impaired glucose tolerance.
“Several studies indicate that upon testosterone administration, serum glucose is reduced after 3 months in men with impaired glucose tolerance (31, 36, 43).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
HbA1c declines after 3 months of testosterone treatment, with further decrease after 12 months.
“A decline in HbA1c was observed after 3 months (31, 36, 43) with further decrease after 12 months (43).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
Serum proinsulin and insulin decrease after 3 or 6 months of testosterone treatment, and HOMA-IR decreases after 3 or 6 months.
“A decrease in serum proinsulin and insulin was noted after 3 months (43) or 6 months (45), and a decrease in homeostasis model assessment index of insulin resistance (HOMA-IR) after 3 months (36) or 6 months (45–47).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [36]
Testosterone replacement can improve performance, mood, and libido in men with hypogonadism and augments insulin sensitivity.
“Certainly, testosterone replacement can improve performance, mood, and libido in men with hypogonadism (22) and augments insulin sensitivity (11,15).”
From Low testosterone levels are common and associated with insulin resistance in men with diabetes (2008) · cites this paper as [11]
Testosterone plays an important role in maintaining glycemic control.
“T plays an important role in maintaining glycemic control [2].”
Testosterone replacement therapy improves insulin resistance, glycemic control, cholesterol levels, and waist circumference in diabetic men with low testosterone levels.
“Furthermore, there is recent evidence that testosterone replacement therapy improves insulin resistance, glycemic control, cholesterol levels, and waist circumference in diabetic men with low testosterone levels (26).”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [26]
Testosterone treatment reduces insulin resistance in obese men, men with heart failure, and type 2 diabetic subjects.
“Testosterone treatment has also been shown to reduce insulin resistance in obese men (23,24), men with heart failure (25), and type 2 diabetic subjects (26).”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [26]
Two studies in type 2 diabetic men have shown an improvement in glycemic control with testosterone replacement therapy.
“Two studies in type 2 diabetic men have shown an improvement in glycemic control (26,27) with testosterone replacement therapy”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [26]
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- Authors
- Kapoor, D., Goodwin, E., Channer, K. S., & Jones, T. H.
- Affiliations
- Barnsley Hospital NHS Foundation Trust (GB)
- National Health Service (GB)
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-06
- Volume
- 154
- Issue
- 6
- Pages
- 899-906
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2142908894
- Cited by
- 791
- References
- 45
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 13 · 2023: 23 · 2022: 27 · 2021: 34 · 2020: 27 · 2019: 32 · 2018: 38 · 2017: 39 · 2016: 38 · 2015: 55 · 2014: 61 · 2013: 55 · 2012: 43
- FWCI
- 36.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- testosterone replacement therapy, hypogonadism, type 2 diabetes, insulin resistance, glycemic control, visceral fat, hypercholesterolemia, dyslipidemia, HbA1c, waist circumference, cardiovascular risk
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Double-Blind Method, Humans, Hypercholesterolemia, Hypogonadism, Insulin Resistance, Male, Middle Aged, Testosterone, Cross-Over Studies, Hormone Replacement Therapy, Abdominal Fat
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