The Link Between Diabetes And Low T
Many of the men who suffer from type 2 diabetes also have low T levels. A recent study showed that 43% of type 2 diabetic men have reduced total testosterone levels, and 57% have lower free testosterone levels. The two main factors impacted by testosterone levels are insulin sensitivity and glycemic control. Insulin resistance occurs when your bodys ability to respond to insulin is compromised in some way. Glycemic control refers to blood sugar level management for those with diabetes.
Insulin resistance is also linked to low levels of both total testosterone and free testosterone. Those with higher levels of SHBG also tend to have poorer glycemic control. Therefore, low testosterone often accompanies diabetes.
Testosterone And Insulin Resistance
One of the clearest links between testosterone and diabetes is the relationship between low testosterone and insulin resistance.
When your body isnt responding normally to the insulin your pancreas produces, its referred to as insulin resistance.
To maintain normal blood sugar levels, your pancreas will work harder to produce more insulin. Over time, its hard to keep up with the demand. And this then leads to gradually increasing blood sugar levels, too.
Bit by bit, your blood sugar levels are rising until you suddenly learn at your routine check-up that your HbA1c is high enough to qualify as pre-diabetic which can later turn into type 2 diabetes.
You might also notice youre also gaining fat more easily and lose muscle mass more easily which just adds further to insulin resistance.
Muscle helps manage blood sugar levels and insulin resistance by burning more calories even when youre resting. The less testosterone you produce, the more muscle youll lose and the more calories youll store as body fat, which then increases insulin resistance and blood sugar levels.
Its a complicated system, and everything is affected! When your hormones are struggling, your blood sugar struggles. When your blood sugar struggles, your hormones struggle.
Testosterone Replacement Therapy And The Risk Of Hypoglycemia
Pablo René Costanzo
Abstract
We report the case of a 45-year-old man with a history of Klinefelter syndrome undergoing testosterone replacement therapy, and with type 2 diabetes treated with metformin with poor metabolic control. When vildagliptin was added to his treatment, he presented hypoglycemia after the testosterone injection. We highlight this not widely reported drug interaction between hypoglycemic agents and testosterone.
1. Introduction
The use of testosterone as replacement therapy in patients with hypogonadism induces metabolic changes that lead to higher insulin sensitivity . In addition, there is an increased glucose uptake by muscle cells . This effect of testosterone therapy may be associated with a higher risk of hypoglycemia in patients with type 2 diabetes under treatment. The interaction of testosterone with insulin has been frequently reported, while little is known about the interaction between testosterone and oral hypoglycemic agents when these drugs are concomitantly administered in hypogonadal men with DM2 .
The aim of the publication of this case is to report the risk of hypoglycemia in hypogonadal diabetic patients treated with oral hypoglycemic agents and testosterone.
2. Case Report
3. Methods
Blood samples were taken at 8:00 AM after 12-hour nocturnal fasting.
InsulinTotal TestosteroneBioavailable TestosteroneGlucoseOGTT
Pharmacokinetics and pharmacodynamics of the drugs used by this patient.
4. Discussion
Conflicts of Interest
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Minimize Stress And Cortisol Levels
Research often highlights the dangers of long-term stress, which can elevate levels of the hormone cortisol .
Sudden elevations in cortisol can quickly reduce testosterone. These hormones often work in a seesaw-like manner: As one goes up, the other comes down .
Stress and high cortisol can also increase food intake, weight gain, and the storage of harmful body fat around your organs. In turn, these changes may negatively affect testosterone levels (
To maintain healthy levels of vitamin D, try to get regular exposure to sunlight or consider taking a vitamin D3 supplement as directed by a healthcare professional.
Summary
Some studies have found that low levels of vitamin D could be associated with decreased testosterone levels. However, more research is needed to determine whether supplementation may be beneficial.
Sex Steroid Actions Beyond Circulating Testosterone
It is well recognized that relating a serum testosterone level to a clinical phenotype is an oversimplification, given that circulating testosterone levels, whether free or total , are unlikely to accurately reflect androgen action at the tissue level. Indeed, testosterone not only directly transactivates the AR but also acts via dihydrotestosterone and estradiol . DHT may mediate, at least in part, the metabolically favorable changes in body composition observed with testosterone therapy because, in a recent RCT of healthy men, DHT treatment significantly increased lean body mass and decreased fat mass, despite decreasing total testosterone to less than 5 nmol/liter . Furthermore, testosterone action is modulated by AR polymorphisms , as well as by transcriptional cofactors , likely in an age- and tissue-dependent fashion. Not surprisingly, therefore, circulating testosterone concentrations account for only 4067% of the variance in fat-free mass and muscle size . In addition, local androgen synthesis and inactivation may not be reflected in circulating testosterone levels .
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Ideal Fat Percentage In Healthy Humans
If you are able to maintain around 20-24% body fat, then it would be healthy.
Check out the ideal fat percentage looking into your age and gender
Leg Exercise , Squats , dead lifts
Food rich in Vitamin D like egg yolk, tuna, beef, oyesters, shell fish, legumes, etc
Reduce Stress – Stress releases cortisols which blocks the effects of testosterone
Herbal medicines like Gokshura and Ashwagandha are good test boosters
It is suggested to avoid using any other forms like injections or any other drugs without consulting your doctor.
Changes In Fat And Insulin Resistance: Effects On Testosterone
Although the above studies show that changes in testosterone lead to changes in body composition and insulin resistance, there is also evidence for the reverse. Prospective, observational studies show that adiposity and the MetS predict the development of low testosterone levels . Moreover, large prospective cohort studies in U.S. and German men showed that weight gain and development of diabetes or the MetS accelerated the age-related decline in testosterone, suggesting that this decline may be at least partially prevented through management of lifestyle factors. Similarly, in diabetic men followed longitudinally, changes in testosterone levels over time correlated inversely with changes in insulin resistance, suggesting that improved lifestyle factors or altered pharmacological management that improved insulin sensitivity also contributed to increased testosterone levels . Consistent with these observational studies are findings that both weight loss and exercise increase testosterone levels.
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Testosterone Therapy And Glycaemic And Metabolic Control
Prospective, observational studies show that visceral adiposity, smoking and the metabolic syndrome predict the development of low testosterone levels . Large prospective USA cohort studies and in Germany men showed that weight gain and development of diabetes or the metabolic syndrome accelerated the age-related decline in testosterone. In men with T2DM followed longitudinally, changes in testosterone levels over time correlated inversely with changes in insulin resistance, suggesting that improved lifestyle factors or altered pharmacological management that improved insulin sensitivity may also contribute to increased testosterone levels . Observational studies found that both weight loss and exercise increase testosterone levels . Bariatric surgery improves glycaemic control and testosterone levels but there are clearly implications of cost and the selection of appropriate patients .
Changes from baseline in body composition after 56 weeks treatment with intramuscular testosterone undecanoate or placebo . Data from Ng Tang Fui et al .
A large-scale study in the Australia, the T4D study is due to report on the possible reduction of incident diabetes by treating younger obese men with metabolic syndrome with TU .
In a small study of 24 patients, Kapoor et al found that Testosterone Enanthate every 2 weeks for 12 weeks lowered HOMA-IR by 1.7 units and HbA1c by 0.37%, with slight reduction in total cholesterol.
Maintain A Balanced Diet
Research has long shown that eating well is essential to maintaining testosterone levels and overall health. According to one report in the , low testosterone levels and being overweight may contribute to a variety of inflammatory conditions and impaired neurological function.
Additional research showed overeating and yo-yo dieting disrupted hormone levels. This effect is most evident in athletes and people who are very active.
The best diets are ones that include mostly whole foods and offer a healthful balance of fats, carbohydrates, and proteins. Eating a healthful and nutritious diet can keep all hormones levels in the body balanced and promote optimal long-term health.
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Studies Suggesting Reduction In Cardiovascular Events
The various metabolic benefits in terms of improved insulin resistance, reduced fat mass, increased lean muscle mass, and reduction in inflammatory markers might be expected to translate into a reduction in CV risk. Inadequate therapy might leave the patient at increased risk of undertreated HG, such that trials need to be assessed in terms of adequate compliance and evidence of sustained treatment to therapeutic levels .
Two longitudinal studies have assessed long term mortality, exclusively in men with T2DM.
In a prospective study involving 587 men with T2DM , patients were followed-up for a mean of 5.81 years. Low testosterone was defined as TT< 10.4 nmol/L. Fifty-eight men received testosterone therapy for at least 2 years. The mortality rates were 20% in the untreated group vs. 9.1% in the untreated group, independent of comorbidities and therapies, and 8.6% in the treated group.
Estimated mortality probability and 95% confidence intervals from fitted logistic regression: men on all or none of the treatments testosterone replacement therapy, phosphodiesterase type 5 inhibitor, or statin). Data from Hackett et al .
In a retrospective study involving 1,031 hypogonadal men, 372 of whom took T therapy, the cumulative mortality was 21 %in the untreated group vs. 10 % in the treated group. The greatest effect was observed in younger men and those with T2DM .
How Diabetes And Testosterone Link
Testosterone levels and diabetes go hand in hand. A man with diabetes is more likely to have low testosterone and a man with low testosterone may also have diabetes. It just depends on the man to see what caused what.Since testosterone levels can change where fat is stored within the body, it can have a large impact on health. If the testosterone is distributing fat more through the visceral fat, fat stored in the abdominal organs, then it is more likely that type 2 diabetes can occur.Men with low testosterone may also be more insulin resistant than others. This means that they will need to create more insulin to deal with the extra blood sugar. However, if they can not, diabetes may appear.
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Can Diabetics Take Testosterone Therapy
Our content is reviewed by a team of medical professionals to ensure you get objective and comprehensive health information. Learn more about our Medical Review Board
Although many do not consider diabetes to be a significant disease like heart disease or cancer. But it is still a deadly condition for numerous Americans.
In fact, it is ranked as the seventh leading cause of death in the United States, and nearly 10 percent of Americans are currently dealing with diabetes.
Diabetes is grouped into two main categories, known as type 1 and type 2. Type 1 is insulin-dependent diabetes and is an autoimmune disease in which the body attacks the pancreatic cells that create insulin.
On the other hand, diabetes type 2 is known as adult-onset diabetes and is far more commonly seen. Although a cure has not yet been found for either type of diabetes, some medications and therapies have been studied over the years and have been found to be quite effective at limiting the symptoms and the side effects of the disease.
For example, testosterone injections and diabetes have been studied in recent years to see how levels of this hormone may affect those diagnosed with this disease.
Is Testosterone Related To Diabetes
There are research showing that low level of testosterone and diabetes has relationship. Is it because of diabetes the testosterone level goes down or the other way round?
Testosterone plays in important role in fat storage – Subcutaneous and Visceral
Subcutaneous means under the skin and visceral means around the abdominal area.
Low testosterone level has shown increase storage of fat near the abdominal area in men and high testosterone level in women has shown storage of fat around the abdomen which is one of the reason for diabetes or insulin insensitivity.
Low testosterone level is a reason for low libido and motivation, loss of muscle mass and could be diabetes.
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Additional Ui Design And Readability Adjustments
The Case Of Soy And Testosterone
While there is a common belief that eating soy will give you higher estrogen, this is not necessarily the case.
Soy contains plant estrogens or phytoestrogens, which mimic the effects of this female hormone. However, this form of estrogen may not have a negative impact on your health.
On the other hand, soy protein concentrate has been shown to decrease testosterone levels in some studies for this reason, it has been proposed as a possible treatment for prostate cancer. In another study, neither whey nor soy protein caused an alteration in hormone levels .
When it comes to soy, use common sense and moderation, and you should be fine.
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Fasting Insulin Sensitivity And Glycaemic Control
In the 14 patients taking oral agents, insulin sensitivity, as measured by the HOMA index, improved on testosterone treatment as compared with placebo. The mean treatment effect and 95% confidence intervals of testosterone on the HOMA index was a reduction as compared with placebo . This effect was explained by a reduction in both fasting glucose and fasting insulin , though only the effect on fasting glucose was statistically significant . Glycated haemoglobin was reduced as a consequence of improved insulin sensitivity. The mean treatment effect of testosterone on HbA1c was a reduction as compared with placebo . Of the 10 patients on insulin, 5 patients reduced their daily insulin dosages, whilst on testosterone treatment, by a mean of 7 ± 1.9 units.
Low Testosterone And Increased Cardiovascular And All
Numerous long-term studies, and various reviews and meta-analyses, have provided evidence to support the association between testosterone deficiency and increased cardiovascular and all-cause mortality , although evidence for a pathogenic link is lacking .
A systematic review and meta-analysis evaluating the association between endogenous testosterone and mortality concluded that low levels of endogenous testosterone are associated with an increased risk of all-cause and CV death in community-based studies of men, with a reduction of 2.1 standard deviations in TT being associated with a 25% increase in mortality. However, most of the studies had issues with cohort selection and choice .
Two systematic reviews and meta-analyses evaluating the association between endogenous testosterone and all-cause mortality and cardiovascular disease mortality reported a protective effect of increased TT. Research examining the data from 1,954 subjects, in terms of several statistical models, found that even after strict adjustment for comorbidities, there was a consistent link between testosterone level and mortality risk throughout, without proving causation .
In a 10-year Australian study involving 3,690 older men, TT and FT levels in the normal range were associated with reduced all-cause and CV mortality. This was the first evidence to suggest that that both low and high levels are associated with all-cause mortality, and higher levels of dihydrotestosterone reduce CV risk .
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The Bottom Line On Testosterone Boosters Testogen And Diabetes
The benefits of testosterone boosters consist of enhanced energy and endurance, more powerful muscles, and a stronger sex drive. Testosterone boosters can likewise have negative effects, such as increased body fat, reduced bone density, and lowered cholesterol levels.
Before you buy a testosterone booster, it is vital to weigh the benefits and dangers and decide which is best for you. Testosterone boosters can have several benefits, such as increasing muscle mass, improving energy levels, and increasing sex drive.
Testosterone boosters can also have dangers, such as increasing the risk of heart prostate, disease, and stroke cancer. It is necessary to weigh the threats and benefits of each testosterone booster before making a decision. Testogen And Diabetes
There are a few possible side effects of using testosterone boosters. These can depend on the individual however can include: increased hostility, acne, loss of hair, and weight gain. If you experience them, it is vital to be conscious of these potential side effects and to speak with a physician.
For males over 30, possibilities are you have actually thought about taking a testosterone booster. As we age, our testosterone levels naturally decline. This can lead to numerous issues, including low energy levels, reduced sex drive, and anxiety.