Endocrine Abstracts (2009) 20 P432

Can testosterone therapy be included into diabetes treatment in men with metabolic syndrome and hypogonadism?

Svetlana Kalinchenko1, Farid Saad2, George Mskhalaya3 & Yuliya Tishova3

1PFUR, Medical faculty, Chair of Clinical Andrology, Moscow, Russian Federation; 2Department of Men’s Healthcare, Bayer Schering Pharma, Gulf Medical University School of Medicine, Ajman, UAE; 3Research Center for Endocrinology, Moscow, Russian Federation.

Background: In 1998 the UKPDS study showed that over 10 years of observation there were no significant changes in haemoglobin A1c (HbA1c) in intensive insulin therapy group compared with conventional therapy group. Therefore, we still need new options to treat diabetes. Diabetes mellitus type 2 (DMT2), is one of the MS components. Obesity leads to insulin resistance (IR) and DMT2. Androgen deficiency (AD) is well-known factor to predict the development of diabetes.

Objective: To study the glycaemic status and changes in hypoglycemic therapy in men with androgen deficiency (AD), MS and DMT2, treated with testosterone undecanoate (TU).

Materials and methods: Of 18 men with MS (IDF criteria), DMT2 (6 patients were on insulin therapy) and AD (total testosterone (TT) <12 nmol/l or free T <250 pmol/l) were treated with TU (Nebido, Schering) for 102 (72;132) weeks. Fasting plasma glucose (FPG), HbA1c, TT and hypoglycemic therapy were estimated at baseline and at the endpoint. Statistical analysis was performed using Wilcoxon test and Spearman correlation test.

TT, nmol/l (NR 12–33)FG, mmol/l (NR 3.3–6.4)HbA1c, % (n=11)Insulin, U (mean)Sulfonylurea+ biguanidesBiguanides monotherapy
Baseline10.1 (9.3;12.4)9 (7.3;10.8)8.9 (8;10.8)44.538.8% (n=7)22.2% (n=4)
Endpoint16.4 (13.2;20)7.55 (6.7;8.7)7.1 (7;7.9)1411.1% (n=2)55.5% (n=10)

Results: Of 3 patients were withdrawn from insulin. A negative correlation between duration of treatment and HbA1c at the endpoint was found (r=−0.67).

Conclusion: AD correction in men with MS and DMT2 improves glycaemic parameters and gives the opportunity to withdrawal from insulin treatment. Biguanides monotherapy is more preferable in DMT2 treatment in men with MS. Level of diabetes compensation depends on duration of testosterone treatment. Testosterone therapy can be included into diabetes treatment in men with metabolic syndrome (MS) and hypogonadism together as well as lifestyle modification and conventional therapy.

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