Endocrine Abstracts (2017) 49 N1.2 | DOI: 10.1530/endoabs.49.N1.2

Clinical practice overlap and seamless care - links between hypogonadism, the metabolic syndrome and type 2 diabetes

Andrew Dwyer


There is a bi-directional relationship between hypogonadism and type 2 diabetes and the metabolic syndrome (T2DM/MetS). Studies show that up to 50% of men with MetS/T2DM have testosterone deficiency. Moreover, both hypogonadism and MetS confer increased health risk for morbidity and mortality. Men with MetS are twice as likely to develop cardiovascular disease and have a fivefold higher risk for developing T2DM. Notably, the inverse relationship between testosterone and MetS is consistently observed across racial and ethnic groups. Therefore, in the setting of ever increasing obesity rates, the relationship between the reproductive endocrine axis and metabolism warrants renewed attention. Using a case-based approach, this presentation will provide an overview of the pathophysiologic basis for the relationship between hypogonadism and MetS/T2DM. Male patients may be trapped in the vicious cycle of hypogonadism-obesity-insulin resistance. We will review an evidence-based approach to the patient including the appropriate evaluation and treatment based on existing guidelines and recommendations. This presentation will have a particular focus on the role of the endocrine nurse in managing patients who present with this confluence of endocrine disorders. Current challenges in the field will be highlighted and we will touch on some yet unanswered questions as well as envisioned future directions. At the conclusion of this session participants will be able to:

• describe the interrelationship between hypogonadism and MetS/T2DM

• identify those patients who warrant screening for androgen deficiency

• recognize barriers to providing integrated care for these patients

• examine how their nursing care for these patients may be improved

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