Endocrine Abstracts

Several studies have shown that men with obesity, insulin resistance, prediabetes, and type 2 diabetes mellitus (DM2) have significantly lower testosterone (T) levels and a higher prevalence of hypogonadism than men with normal metabolic status. It is estimated that between 30 and 40% of men with T2DM have low levels of T, assessed as total T, free T, or bioavailable T. But, as part of the integrative metabolic system, testosterone has insulin-sensitizing hormone properties through several mechanisms. So, the metabolic state and the reproductive axis are normally in a balance of mutual convenience. In that sense, while low T is a risk factor for a future metabolic condition, any metabolic condition is a risk factor for developing low T. I will discuss the evidence for the utility of testosterone replacement therapy in hypogonadal men to improve metabolic status. In men undergoing treatment with changes to healthier habits, does the addition of exogenous T improve the results of these treatments?