Low testosterone levels are common and associated with insulin resistance in men with diabetes

Mathis Grossmann, Merlin C. Thomas, Sianna Panagiotopoulos, Ken Sharpe, Richard J. MacIsaac, Sophie Clarke, Jeffrey D. Zajac, George Jerums

Research output: Contribution to journalArticleResearchpeer-review

291 Citations (Scopus)

Abstract

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: The study was a 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 6 months. Results: Forty-three percent ofmenwith type 2 diabeteshada reduced total testosterone, and 57% had a reduced calculated free testosterone. Only 7% of men with type 1 diabetes had low total testosterone. By contrast, 20.3% of men with type 1 diabetes had low calculated free testosterone, similar to that observed in type 2 diabetes (age-body mass index adjusted odds ratio = 1.4; 95% confidence interval = 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, whereas the utility of testosterone replacement remains to be established in prospective trials.

Original languageEnglish
Pages (from-to)1834-1840
Number of pages7
JournalThe Journal of Clinical Endocrinology and Metabolism
Volume93
Issue number5
DOIs
Publication statusPublished - 1 Jan 2008
Externally publishedYes

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