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Type 2 Diabetes and Testosterone Therapy.

Geoffrey Hackett1

  • 1Department of Urology, Good Hope Hospital, Heart of England Foundation Trust and University of Aston, Birmingham, UK. hackettgeoff@gmail.com.

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|August 7, 2018
PubMed
Summary
This summary is machine-generated.

Men with type 2 diabetes and hypogonadotrophic hypogonadism face higher mortality risks. Testosterone therapy shows potential benefits, but current research is inconclusive due to study limitations.

Keywords:
Cardiovascular diseasesDiabetes mellitus, type 2HypogonadismMajor adverse coronary eventsTestosterone deficiency

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Cardiovascular Health

Background:

  • A significant proportion of men with type 2 diabetes (T2DM) also have hypogonadotrophic hypogonadism (HH).
  • Both T2DM and HH are independently linked to increased risks of cardiovascular disease and all-cause mortality.
  • HH may also increase the risk of developing incident T2DM.

Purpose of the Study:

  • To review the existing literature on the relationship between T2DM, HH, testosterone deficiency, and mortality.
  • To evaluate the efficacy and limitations of testosterone therapy in men with T2DM and HH.

Main Methods:

  • Comprehensive literature search of MEDLINE, EMBASE, and COCHRANE databases from May 2005 to October 2017.
  • Inclusion of 1,714 articles, 52 clinical trials, and 32 randomized controlled trials (RCTs) for analysis.
  • Focus on studies examining testosterone therapy in the context of T2DM and HH.

Main Results:

  • Testosterone therapy in studies suggests potential benefits for sexual function, quality of life, glycemic control, anemia, bone density, and body composition (fat and lean mass).
  • Meta-analyses of RCTs have yielded confusing results due to methodological issues.
  • Identified limitations include underpowered studies, inadequate duration, varied treatment regimens, and potential biases in study selection.

Conclusions:

  • Testosterone therapy may offer benefits for men with T2DM and HH, but robust evidence is lacking.
  • Current meta-analyses are hampered by the quality and heterogeneity of included studies.
  • Further well-designed, adequately powered, and longer-duration RCTs are needed to clarify the role of testosterone therapy.