Medical 411: Low Testosterone in Men With Obesity and Type 2 Diabetes

by Sandeep Dhindsa, M.D.

Testosterone is the principal sex hormone in males. It is important, not only for normal sexual function, but also for maintaining bone and muscle strength, mental and physical energy and overall well-being.

Research conducted at the State University of New York at Buffalo (SUNY at Buffalo) over the last decade shows one-third of men with type 2 diabetes also have low testosterone concentrations. The major determinant of testosterone concentrations in these men is obesity, and an increase in body weight leads to lower testosterone levels. A quarter of obese men without diabetes also have low testosterone. Our most recent study shows that obese boys at end of puberty have 50% lower testosterone concentrations than lean boys.

We have found that the prevalence of obesity and diabetes is increasing among all age groups and a significant number among them are likely to be in their prime reproductive years. The fact that one-third of these men have low testosterone is significant in terms of inadequate sexual function and potential infertility. However, the problem of low testosterone is not confined to just sexual and reproductive function but also to cardiovascular disease and atherosclerosis (fatty deposits in inner lining of arteries, which are precursors of "heart attack").

Inflammation (the process by which the body responds to injury/infection) is believed to play an essential role in the cause of atherosclerosis. Men with low testosterone have more inflammation and heart disease than those with normal testosterone. This means that urgent measures need to be taken to prevent the massive and progressive epidemic of type 2 diabetes which, in its wake, results in hypogonadism (a condition where sex glands produce little or no hormones), resulting in type 2 diabetes, obesity and heart disease.

Testosterone replacement is indicated in symptomatic men with low testosterone for maintaining secondary sexual characteristics, improving sexual function, sense of well being and bone mineral density, as well as for increasing muscle mass and reducing fat mass. There are different formulations available to replace testosterone: intramuscular injection, gel or patches.

Now the Endocrinology division of SUNY at Buffalo is conducting research studies on the impact of testosterone replacement on body composition, fertility, inflammation and atherosclerosis in men with type 2 diabetes or obesity. To learn more and find out if you are eligible to participate in this important and ongoing research study visit http://diabetes endocrinologycenterofwny.com/index.html or call 716-626-7998.

About the Author:

Sandeep Dhindsa, MD is an American Diabetes Association-funded researcher from State University of New York at Buffalo. Dr. Dhindsa and Paresh Dandona, MD were the first researchers to assess the prevalence of hypogonadism in men with diabetes and obesity. Dr. Dhindsa recommends that men with either obesity or diabetes have their testosterone levels tested regularly.