Androgen Therapy in Male Patients Suffering from Type 2 Diabetes: A Review of Benefits and Risks

Curr Diabetes Rev. 2020;16(3):189-199. doi: 10.2174/1573399814666180731125724.

Abstract

Background: The current estimated numbers of patients with Type 2 Diabetes (T2D) is believed to be close to 10% of the whole populations of many geographical regions, causing serious concerns over the resulting elevated morbidity and mortality as well as the impact on health care systems around the world. In addition to negatively affecting the quality of life, diabetes is associated with cardiovascular and cerebrovascular complications, indicating that appropriate drug therapy should not only deal with metabolic dysfunction but also protect the vascular system, kidney function and skeletal muscle mass from the effects of the epigenetic changes induced by hyperglycaemia.

Objective: To provide an insight into the management of hypogonadism associated with T2D, this review focuses on clinical observations related to androgen therapy in qualified diabetic patients, and discusses the lines of evidence for its benefits and risks. The potential interactions of testosterone with medicines used by patients with T2D will also be discussed.

Conclusion: From recent clinical findings, it became evident that a considerable percentage of patients suffering from T2D manifested low serum testosterone and experienced diminished sexual activity, as well as reduced skeletal muscle mass and lower bone density. Although there are some controversies, Testosterone Replacement Therapy (TRT) for this particular population of patients appears to be beneficial overall only if it is implemented carefully and monitored regularly.

Keywords: Type 2 diabetes; drug-drug interactions; hypogonadism; insulin resistance; testosterone replacement therapy; vascular system..

Publication types

  • Review

MeSH terms

  • Androgens / adverse effects
  • Androgens / blood
  • Androgens / therapeutic use*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Interactions
  • Hormone Replacement Therapy / adverse effects
  • Hormone Replacement Therapy / methods
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Hypogonadism / drug therapy*
  • Hypogonadism / etiology
  • Male
  • Quality of Life
  • Risk Assessment
  • Testosterone / adverse effects
  • Testosterone / blood
  • Testosterone / therapeutic use*

Substances

  • Androgens
  • Hypoglycemic Agents
  • Testosterone