Men with Latent Autoimmune Diabetes and Type 2 Diabetes May Have Different Change Patterns in Free Testosterone

Area of Science:

• Endocrinology
• Metabolic Disorders
• Andrology

Background:

• Low total testosterone (TT) is linked to increased mortality in type 2 diabetes (T2D) male patients.
• Testosterone levels in male patients with latent autoimmune diabetes in adults (LADA) are not well-documented.
• Understanding hormonal profiles in LADA is crucial for managing this distinct diabetic subtype.

Purpose of the Study:

• To investigate changes in sex hormone concentrations in male LADA patients over a 1-year period.
• To compare androgen level dynamics between LADA and matched T2D patients.
• To explore the relationship between changes in testosterone levels and insulin sensitivity.

Main Methods:

• A single-center, observational study involving male LADA patients.
• Patients were matched with T2D patients based on sex, BMI, C-peptide, and HbA1c.
• Measurements of islet function, insulin sensitivity, and sex hormone concentrations (TT, Bio-T, FT) at baseline and 1-year follow-up.

Main Results:

• In T2D patients, TT and Bio-T remained unchanged, while FT significantly decreased.
• LADA patients showed dramatic increases in TT, Bio-T, and FT levels over 1 year.
• Changes in TT, FT, and Bio-T were negatively correlated with improvements in insulin resistance (HOMA2-IR).

Conclusions:

• Free testosterone (FT) dynamics differ between LADA and T2D patients.
• Insulin sensitivity is significantly associated with changes in total testosterone (TT), free testosterone (FT), and bioavailable testosterone (Bio-T).
• Diabetic duration plays a role in the relationship between insulin sensitivity and androgen levels in both T2D and LADA.