Study finds testosterone replacement therapy does not improve diabetes control in men with low testosterone

Low testosterone levels have long been linked to an increased risk of prediabetes and type 2 diabetes in men. However, recent research suggests that testosterone replacement therapy (TRT) may not be effective in reducing these risks, shedding new light on its role in diabetes prevention.

What the study found

A substudy of the TRAVERSE trial (Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men) delved into this topic. Among the 5204 men aged 45 to 80 years with hypogonadism, 1175 had prediabetes, and 3880 had diabetes. Notably, the mean hemoglobin A1c level in the prediabetes group stood at 5.8% at baseline.

Throughout the study, there were no significant differences observed in the progression to diabetes between men receiving testosterone gel versus those on a placebo. This trend held true at 6, 12, 24, 36, and 48 months into the trial. Furthermore, metrics such as hemoglobin A1c levels, glycemic remission, and fasting glucose reduction showed no notable disparities between the two groups, as reported in JAMA Internal Medicine.

Consequently, the researchers concluded that TRT did not yield improvements in glycemic control among men with hypogonadism and prediabetes or diabetes. This finding challenges previous assumptions about the potential benefits of TRT in managing diabetes-related conditions.

Risks and benefits of testosterone therapy

While previous research has indicated that testosterone therapy does not heighten the risk of cardiovascular events, fractures, or prostate cancer, its benefits beyond addressing symptoms of hypogonadism remain limited. While it may alleviate symptoms such as anemia and sexual dysfunction, evidence suggests that it does not enhance cognitive function.

However, it’s crucial to note that TRT is associated with certain risks, including venous thromboembolism, polycythemia, atrial fibrillation, and acute kidney injury. Given these considerations, TRT should primarily be reserved for addressing bothersome symptoms of hypogonadism, particularly sexual dysfunction like erectile dysfunction.

Moreover, the findings from this study underscore the importance of cautious prescribing practices, particularly in populations without hypogonadism, where TRT may not show significant benefits on glycemic control. This highlights the need for a nuanced approach to TRT, ensuring it is utilized judiciously and by evidence-based guidelines.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911. 




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