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This version published online on March 4, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-2177
A more recent version of this article appeared on May 1, 2008
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Right arrow Diabetes and Insulin
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Submitted on September 27, 2007
Accepted on February 22, 2008

Low Testosterone Levels are Common and Associated with Insulin Resistance in Men with Diabetes

Mathis Grossmann MD, PhD*, Merlin C Thomas MBChB, PhD, Sianna Panagiotopoulos PhD, Ken Sharpe PhD, Richard J MacIsaac MBBS, PhD, Sophie Clarke MBBS, Jeffrey D Zajac MBBS, PhD, and George Jerums MBBS, MD

Department of Endocrinology and Medicine, University of Melbourne, Austin Health, Australia, Baker Heart Research Institute, Melbourne, Australia; Department of Mathematics and Statistics, University of Melbourne, Australia

* To whom correspondence should be addressed. E-mail: mathisg{at}unimelb.edu.au.

Context: Low testosterone levels are common in men with type 2 diabetes and may be associated with insulin resistance.

Objective: We investigated prevalence of testosterone deficiency and the relationship between testosterone and insulin resistance in a large cohort of men with type 2 and type 1 diabetes.

Design: Cross-sectional survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after a median of six months.

Results: Forty-three percent of men with type 2 diabetes had a reduced total testosterone (TT), and 57% had a reduced calculated free testosterone (cFT). Only 7% of men with type 1 diabetes had low TT. By contrast, 20.3% of men with type 1 diabetes had low cFT, similar to that observed in type 2 diabetes (age-BMI adjusted odds ratio 1.4, 95% CI 0.7–2.9). Low testosterone levels were independently associated with insulin resistance in men with type 1 diabetes, as well as type 2 diabetes. Serial measurements also revealed an inverse relationship between changes in testosterone levels and insulin resistance.

Conclusions: Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention, while the utility of testosterone replacement remains to be established in prospective trials.
Key words: diabetes • testosterone • insulin resistance




eLetters:

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Relation of BMI with testosterone in type 1 and type 2 diabetes
Paresh Dandona, et al.
JCEM Online, 30 Apr 2008 [Full text]
Low testosterone levels in men with type 1 diabetes
Mathis Grossmann, et al.
JCEM Online, 27 May 2008 [Full text]

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