The Link Between Low Testosterone and Diabetes | Everyday Health
What do central obesity, high blood pressure, and low testosterone have in common? These are all characteristics of metabolic syndrome. Research into the relationship between low testosterone and several improve blood sugar levels and obesity in men with low testosterone. Data from two observational registries indicated that long-term testosterone replacement therapy in diabetic men was associated not only with.
Testosterone Replacement Therapy Linked to Reducing Blood Sugar Levels?
According to a study published in the European Journal of Endocrinology, once this process starts, the typical rate of decline is between 0. This gradual decrease in testosterone can leave men with less energy and a lower libido. Certain lifestyle habits and physical conditions can speed up the decline in testosterone — and one condition that is linked to low testosterone is diabetes.
A third of American men over age 65 have Type 2 diabetesand roughly the same proportion has low testosterone — with a significant overlap between the two groups. A review article published in the Journal of Endocrinology reports that half of older, obese men with diabetes have low testosterone levels.
Either way, the connection is too strong to ignore. Though the debate about cause and effect continues, some researchers think low testosterone is a strong predictor of insulin resistancea hallmark of Type 2 diabetes.
But other than age, what factors are associated with lower testosterone production? Knowing the answer to this question can support lifestyle choices that might help raise your testosterone levels and, at the same time, make it easier to manage your diabetes. You might think that simply taking a testosterone replacement can reverse the effects of low testosterone. If so, you would be right. Testosterone replacement has been shown to improve insulin sensitivity, among other effects of low testosterone.
Men and Low Testosterone - Diabetes Self-Management
The rest of this article examines some common causes of low testosterone. However, lack of sleep deprives your body of something it needs, so it should be no surprise that a chronic sleep deficit can wreak havoc on your health.
Lack of sleep can also disrupt glucose metabolism — in fact, it may be a better predictor of diabetes than obesity is, according to a study published in the journal The Lancet. Getting more sleep could be a simple solution for people with low testosterone and diabetes. How are sleep and testosterone related? A large testosterone release happens during the last stage of the sleep cycle, a deep sleep during which the body repairs and rebuilds tissues, including bone and muscle, and the immune system.
This result was seen in men in their 20s after only one week of sleep reduction — just imagine the effect that decades of sleep deprivation might have. If you suspect that you have sleep apnea, contact your health-care provider or a sleep study clinic. Symptoms of sleep apnea can include loud snoring, abrupt waking while experiencing shortness of breath, bouts of not breathing during sleep that another person witnesses, difficulty sleeping at night, and daytime sleepiness.
Men entering their 40s tend to have more responsibilities than earlier in their life, which tends to increase their overall stress level. Abstract The relationship between testosterone and diabetes is an important issue, given the fact that diabetes is becoming a fast-growing epidemic, the morbidity associated with which is more disabling than the disease itself.
Various studies have demonstrated the increasing prevalence of hypogonadism in diabetic subjects, but whether this is a cause or effect is still an area of active research. The past couple of decades have witnessed an increasing rate of testosterone prescriptions, even though the relationship between testosterone therapy and cardiovascular effects is still not conclusive.
The studies done in this regard have shown conflicting results, and there is still a dearth of long-term, follow-up studies in this field.
This paper reviews in brief the postulated mechanisms, observational studies, and interventional data regarding the adverse effects of testosterone therapy in type 2 diabetes mellitus, stressing the cardiovascular risks. A number of epidemiological studies have suggested an association of obesity, metabolic syndrome, and dysglycemia with low serum testosterone and poor quality of life in type 2 diabetes.
Low testosterone and diabetes A meta-analysis by Ding et al in 8 showed that men with diabetes had significantly lower levels of serum testosterone when compared with men without diabetes. They also found that men with higher total testosterone concentrations Another meta-analysis by Corona et al 9 similarly showed that men who had lower baseline total testosterone had an increased incidence of incident diabetes in comparison with controls.
In the Third National Health and Nutrition Examination Survey, 10 the investigators studied a cohort of 1, adult men, of whom had diabetes, and found that men in the lowest tertile of free testosterone had an approximately four-fold increased risk of having diabetes when compared with men in the highest tertile of free testosterone, even after adjustment for age, ethnicity, and adiposity. In another cross-sectional study of 1, men by Brand et al, 11 it was shown that diabetic men had not only lower testosterone but also lower levels of sex hormone binding globulin SHBG when compared with non-diabetic men.
In another cross-sectional survey of men with type 2 diabetes and 69 men with type 1 diabetes by Grossmann et al, 12 testosterone deficiency was found to be more common in men with diabetes, regardless of type of diabetes. The Hypogonadism In Males study of 1, men 1, non-diabetic and diabetic showed that testosterone levels were also influenced by the presence of obesity in the study subjects, as they found a negative correlation between testosterone and body mass index, irrespective of whether the subjects had diabetes or not, although diabetic men had a higher prevalence of low free testosterone across all body mass index categories.
High levels of SHBG are associated with lower risk of diabetes. Similar findings were also reported by Perry et al. It is likely that many other undetermined factors also play an important role.
The Link Between Low Testosterone and Diabetes
Role of visceral adiposity Visceral obesity is projected to be an important risk factor for the development of insulin resistance and type 2 diabetes. Free testosterone levels have been reported to be low and correlate inversely with the degree of obesity in obese individuals.
Role of leptin Low total and free testosterone and low SHBG levels are seen in men with obesity, metabolic syndrome, and type 2 diabetes, as shown in previous studies. Whether this is a cause or effect is still unclear, with hypogonadism-induced obesity and obesity-induced androgen deficiency both plausibly contributing to a bidirectional effect on disease pathology.
This in turn leads to decreased testosterone release, causing a state of hypogonadotrophic hypogonadism. Leptin, well known to have a role in regulation of body weight and food intake, also stimulates hypothalamic gonadotropin-releasing hormone neurons that induce the release of luteinizing hormone under normal conditions.
Leptin probably causes these changes by acting on the leptin receptor expressed on kisspeptin neurons, as no leptin receptors are seen on gonadotropin-releasing hormone neurons. In a study of 60 men of mean age These associations of AR CAG with obesity and leptin were independent of testosterone, estradiol, and gonadotropin levels, as well as age.
A less sensitive receptor associated with the longer AR CAG probably results in higher testosterone and luteinizing hormone levels. Men with less transcriptionally active ARs achieve higher testosterone levels that have the potential to offset the clinical effects of the receptor polymorphism. However, in the face of the low testosterone levels seen in patients with diabetes, this polymorphism becomes clinically significant.
Higher testosterone levels seen in men with a less sensitive receptor are not truly compensatory as they may have effects via mechanisms other than the classical AR.
Future research with emerging selective AR modulators might help to decipher the effects of AR stimulation from the overall effects of testosterone. Experimental studies in mice have been conducted to study the role of the AR in insulin resistance. The AR knockout mice also showed increased serum levels of leptin, and weight loss could not be stimulated with exogenous leptin, pointing to leptin resistance as a possible pathology.
These AR knockout mice did not show any improvement in their metabolic abnormalities or insulin resistance with exogenous dihydrotestosterone replacement. An alternative explanation is that the altered release of adipokines in AR knockout mice could lead to skeletal muscle and hepatic insulin resistance.
Another possible mechanism is leptin resistance, which leads to ectopic deposition of triglycerides in non-adipocytes, such as skeletal muscle and liver, which in turn leads to insulin resistance and adipogenic type 2 diabetes.
In a study of diabetic males who were followed up for a mean standard deviation of 5. They also showed that testosterone therapy might improve survival in this group.
In a double-blind, placebo-controlled, crossover study, 41 30 patients with type 2 diabetes and hypogonadism were given testosterone therapy which reduced their homeostatic model assessment index, glycated hemoglobin, and fasting plasma glucose. Conflicting results were seen in another study 45 of 22 men aged 25—50 years with type 2 diabetes mellitus and hypogonadism in which exogenous testosterone supplementation had a neutral effect on the homeostatic model assessment index and markers of glycemic control.
Hence, the effects of testosterone therapy have been shown to be inconsistent in the various studies and further trials will clarify the situation. Testosterone therapy seems to have better effects in obese men with lower basal testosterone levels when testosterone is maintained at mid-normal levels for a longer time with replacement therapy.
A study published in in the journal BioMed Research International found that low testosterone levels may help predict if a man will develop insulin resistance or type 2 diabetes in the future. According to the researchers, in a group of more than obese and non-obese men, 44 percent had both type 2 diabetes and low testosterone, compared with 33 percent who had low testosterone but did not have diabetes. The researchers also noted that 25 percent of those with type 2 diabetes and low testosterone were not obese, concluding that low testosterone is linked to insulin resistance regardless of body weight.
Yet, body weight can be a factor. A study published in the journal Diabetes Care found an inverse relationship between body mass index BMI and testosterone levels in men with type 2 diabetes. That means that as a man's BMI increases, his testosterone level falls. Obesity may also be a reversible risk factor for low testosterone levels. Research also suggests that low testosterone could be a complication of type 2 diabetes involving the pituitary gland.
Researchers also found that the pituitary glands of these men were not producing enough luteinizing hormone, the hormone that triggers the production of testosterone in the testes. Managing Diabetes and Low Testosterone Low testosterone symptoms can include decrease in sex drive, erectile dysfunctionloss of muscle mass, depression, and a lack of energy, Dr. Low testosterone can also cause a decline in bone mass and osteoporosis as well as an increase in belly fat.