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Androgen deficiency and type 2 diabetes mellitus
Fraser W Gibb1, Mark W J Strachan1
1Edinburgh Centre for Endocrinology and Diabetes, UK.
Clinical Biochemistry
|April 29, 2014
Summary
Type 2 diabetes (T2DM) is linked to male hypogonadism, or low testosterone. This review explores the causes, diagnosis, and treatment of this condition in aging men with T2DM.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Men's Health
Background:
- Rising incidence of Type 2 Diabetes Mellitus (T2DM) globally, linked to obesity and aging.
- Association between T2DM, obesity, and aging with increased risk of male hypogonadism (low testosterone).
- Increased testosterone replacement therapy prescriptions in the last decade.
Purpose of the Study:
- To review the pathogenesis, diagnosis, clinical consequences, and management of male hypogonadism in relation to T2DM.
- To explore the complexities in diagnosing androgen deficiency states.
- To examine the established benefits of androgen replacement in younger men versus the less developed evidence in older men.
Main Methods:
- Literature review focusing on male hypogonadism and T2DM.
- Analysis of epidemiological evidence on testosterone deficiency.
- Examination of current therapeutic approaches and their limitations.
Main Results:
- Testosterone deficiency is common in men with T2DM (prevalence of 33% in one cohort).
- Pathogenic mechanisms for diabetes-related hypogonadism are unclear, with multiple theories.
- Limited evidence supports a protective effect of testosterone replacement on cardiovascular disease and mortality.
Conclusions:
- Male hypogonadism is a significant concern in the context of T2DM.
- Diagnosis requires careful consideration of biochemical and clinical factors.
- Further research is needed on the benefits and safety of testosterone replacement in older men, particularly for non-sexual symptoms.
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