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Over the years, researchers found out that there is a significant connection between low testosterone and diabetes. In fact, men with type 2 diabetes are twice as likely to have low testosterone levels compared to men who don’t have diabetes. [304] Low levels of testosterone in men are associated with insulin resistance or reduced insulin sensitivity. [305] Insulin resistance is a medical condition wherein your body produces insulin but does not use it properly. This in turn lead to accumulation of blood sugar in the bloodstream rather than being absorbed by the cells to be used as a source of energy. Over time, insulin resistance can lead to type 2 diabetes and other health problems.
There is increasing evidence that testosterone can help improve blood sugar levels by correcting insulin resistance. For instance, a study conducted by Kapoor et al. investigated the effect of testosterone treatment on insulin resistance and glycaemic control (blood sugar levels) in 24 hypogonadal men aged 30 and above with type 2 diabetes. [306] The researchers found that testosterone replacement therapy reduced insulin resistance and improved blood sugar levels in all participants.
A similar study involving 48 middle-aged men (24 subjects received testosterone undecanoate for 3 months and 24 did not) with type 2 diabetes and symptoms of testosterone deficiency showed that oral testosterone undecanoate treatment improves blood sugar levels, decreases visceral obesity and improves symptoms of testosterone deficiency including erectile dysfunction. [307] In all of the participants, the benefit of oral testosterone supplementation therapy exceeded the correction of symptoms of testosterone deficiency.
Several interventional trials have also reported that testosterone improves blood sugar levels in people with type 2 diabetes by reducing the levels of various inflammatory markers, improving visceral obesity, and enhancing the body’s response to the effects of insulin. [308-310] Improvements in these parameters can also improve one’s quality of life by lowering one’s risk of diabetes as well as other fatal disorders. In fact, in a study of 581 diabetic males who were followed up for several years, Muraleedharan et al. found that men with low testosterone levels had a high mortality rate of 17.2% as compared with 9% in men with normal testosterone. [311-315]
Other high quality studies have also shown that testosterone replacement therapy may help improve symptoms of diabetes by stabilizing blood sugar levels and improving the body’s response to the effects of insulin. [316] These beneficial effects ultimately lead to a lower risk of complications from diabetes and improved quality of life.
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