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Testosterone Replacement Therapy and Diabetes

testosterone replacement therapy and diabetes

If you’re a man over 40 and feeling drained, irritable, depressed and carrying extra body weight, low testosterone may be to blame. But the impact of declining testosterone levels goes far beyond just mood and energy. New research shows low testosterone is linked to insulin resistance and diabetes, opening the door to a cascade of cardiovascular disease, adverse metabolic effects, and sexual dysfunction.

The good news is that testosterone replacement therapy offers new hope for improving glycemic control, boosting energy, sharpening mental focus and reducing diabetes complications like neuropathy, retinopathy and nephropathy. Read on to learn more about the vital role testosterone plays in men’s health and how hormone therapy can be a game changer if you have hypogonadism or late-onset hypogonadism.

The Connections Between Low Testosterone, Diabetes and Men’s Health

Testosterone levels start to decline in men after age 30, dropping about 1-2% per year. This slow drain can lead to fatigue, loss of muscle mass, sexual dysfunction, increased visceral adiposity, and depression. Doctors call this age-related decline in testosterone levels late-onset hypogonadism.

For diabetic patients, low testosterone and hypogonadism are even more prevalent. A study shows 37% of men with Type 2 diabetes have abnormally low serum testosterone levels. These patients showing symptoms of hypogonadism were identified at 17% with primary hypogonadism, and 83% with secondary hypogonadism. 

Several reasons behind this close relationship between low testosterone, insulin resistance, and diabetes in men are:

  • Low testosterone promotes increased central obesity and visceral adiposity, which drive insulin resistance and boost diabetes risk.
  • Testosterone helps regulate glucose metabolism through its actions on insulin sensitivity and glucose uptake in muscles. Low testosterone reduces these beneficial metabolic effects.
  • Testosterone boosts lean muscle mass, which helps stabilize blood sugar. Loss of muscle mass from low T worsens insulin resistance.
  • Testosterone enhances beta cell function and insulin secretion, which improves glycemic control. Declining testosterone impairs insulin production over time.

Given the mechanisms linking low testosterone and diabetes, treatment with testosterone replacement therapy offers tantalizing benefits for men’s health. Studies show testosterone therapy can improve HbA1c, fasting glucose, insulin sensitivity, body composition, lipid profiles and sexual function in men with hypogonadism.

Let’s explore the evidence on testosterone’s effects on diabetes and glucose regulation in more detail.

Can Testosterone Therapy Improve Diabetes Control and Blood Sugar Levels?

The potential for testosterone therapy to improve diabetes control and blood sugar levels can be shown through several key mechanisms:

1Testosterone helps build lean muscle mass by promoting protein synthesisMore muscle tissue facilitates better blood glucose control by increasing the body’s capacity to take up glucose from the bloodstream. Loss of muscle mass is closely linked to worsening insulin resistance.
2Testosterone therapy reduces visceral and abdominal fat depositsExcess visceral adiposity drives many metabolic abnormalities and is tightly associated with insulin resistance and diabetes risk. Testosterone acts to decrease waist circumference and central obesity.
3Testosterone enhances insulin signaling at the cellular level and directly improves insulin sensitivityIt appears to act through pathways involved in glucose uptake and utilization.
4Testosterone may help preserve and protect insulin-producing pancreatic beta cells.Maintenance of beta cell function allows for better endogenous insulin production and glycemic control.

While these potential mechanisms show promise, larger and longer clinical trials are still needed to fully confirm the benefits of testosterone therapy for diabetes management. As with any medical treatment, close monitoring of patients is essential to ensure safe and effective therapy.

Does Testosterone Therapy Raise Heart Risks for Diabetic Men?

One concern surrounding testosterone replacement therapy is its potential impact on cardiovascular health and risk factors like blood pressure, endothelial function, and lipid parameters.

Some studies have flagged a potential increase in cardiovascular events like heart attack and stroke risk from testosterone treatment, especially in older men with existing coronary heart disease.

However, the evidence on cardiovascular effects is mixed. A 2018 review analyzed 27 placebo-controlled studies on testosterone therapy in men, including those with metabolic disease and late-onset hypogonadism. The researchers concluded that testosterone treatment provided several benefits, including improving endothelial function, reducing inflammatory cytokines, increasing insulin sensitivity, and lowering triglycerides.

When it comes to diabetic men considering testosterone therapy, regular cardiac monitoring is prudent. Follow-up is key to catch any signs of fluid retention, edema or adverse lipid changes that may increase cardiovascular risks. Adjusting diabetes medications and dosing testosterone appropriately can help mitigate these effects.

Doctors also monitor hematocrit and hemoglobin levels during treatment. Increased red blood cell mass is a known side effect that could potentially raise heart attack or stroke risk in some cases.

Is Testosterone Replacement Therapy Right For You

The evidence suggests testosterone therapy can potentially improve diabetes control, metabolism, sexual function, strength and cognition in symptomatic men with hypogonadism or low testosterone levels. But is it right for you?

Here are some key factors to weigh in consultation with your physician:

  • Get thorough lab screening: Measuring total and free testosterone levels at more than one time point ensures an accurate diagnosis of hypogonadism.
  • Assess your symptoms: Do you suffer from low energy, diminished strength, low libido, erectile dysfunction? These can indicate low T.
  • Consider lifestyle changes first: Improving diet, activity, sleep and stress may naturally boost testosterone.
  • Review all health risks: Discuss your personal risk factors for potential side effects like prostate issues, sleep apnea and heart problems.
  • Set clear treatment goals: Are you hoping to improve sexual function, gain strength, enhance cognition or reduce diabetes complications?
  • Commit to ongoing monitoring: Follow-up is crucial to ensure testosterone therapy is improving your health, not exacerbating risks. This includes lab tests, blood pressure checks and symptom reviews.
  • Use together with diabetes management: Testosterone therapy complements, but does not replace standard diabetes treatment and healthy lifestyle changes.
  • Involve your partner: Keep your spouse or partner informed since testosterone therapy impacts relationships and intimacy.

Natural Ways to Boost Testosterone Levels for Diabetic Men

Along with testosterone replacement therapy, there are several evidence-based lifestyle changes diabetic men can make to naturally support healthy testosterone levels:

  • Exercise regularly with both aerobic and resistance training to boost testosterone production and improve insulin sensitivity. Start slowly and work up to 150 minutes of moderate activity per week.
  • Lose weight if overweight or obese to increase total testosterone. Even small amounts of weight loss can make a difference. Follow a healthy diabetic diet focused on lean proteins, fruits, vegetables and whole grains.
  • Get 7-9 hours of quality sleep per night. Lack of sleep disturbs testosterone production and metabolic health. Develop good sleep habits for better rest.
  • Reduce stress through relaxing activities like yoga, meditation, music or spending time outdoors. Chronic stress raises cortisol which can suppress testosterone.
  • Consume foods rich in zinc, vitamin D and magnesium such as oysters, fatty fish, beans, nuts and leafy greens. Deficiencies in these nutrients are linked to low testosterone.
  • Increase vitamin D intake from sunlight, fortified foods or supplements if deficient. Optimal vitamin D levels support healthy testosterone.
  • Limit refined carbohydrates and added sugars which can impair testosterone levels. Eat a balanced diabetic diet.

Making positive lifestyle modifications enables diabetic men to improve low testosterone while also managing blood sugar and reducing diabetes complications. Consult your physician about realistic goals for exercise, nutrition and stress reduction.


Testosterone replacement therapy offers new hope for improving glycemic control, body composition, sexual function and energy in diabetic men suffering from hypogonadism. While more research is still needed, early studies demonstrate the potential for testosterone treatment to reduce HbA1c, fasting glucose, triglycerides, and waist circumference when used as part of a comprehensive diabetes management plan.

Men with diabetes should have testosterone levels checked and weigh the pros and cons of hormone therapy in consultation with their physician. With proper monitoring and reasonable precautions, testosterone replacement could provide transformative benefits for men’s health.

Get in Touch Today!

Contact Physician’s Rejuvenation Centers today to schedule a screening. Our experts will test your testosterone levels, assess your symptoms, and review your health history to determine if hormone therapy is right for you. We develop customized treatment plans to help men optimize vitality, strength, mental acuity and metabolism. Don’t wait to start feeling like yourself again. Call 561-783-5153 now to take control of your health and schedule a consultation.

Our skilled physicians specialize in reputable, results-driven testosterone replacement therapy for men. Contact us today to find out if our customized programs can help you reclaim your health and vitality!