Testosterone deficiency and type 2 diabetes

Male hypogonadism or testosterone deficiency syndrome tends to occur more frequently at older ages, although it can begin as early as age 40.

Prevalence data are highly variable, but it is estimated that 6-12% of the general population may have it. It is much more frequent in men with type 2 diabetes, affecting one third of them.

What is the relationship between male hypogonadism and type 2 diabetes?

This relationship is demonstrated by different studies which, in addition, highlight the influence of cardiovascular problems. Given that the diabetic population has a higher prevalence of cardiovascular disease (one of the leading causes of death), early detection of this syndrome makes it possible to address other risk factors for its prevention.

The association of hypogonadism with cardiovascular risk could explain the mortality rates observed in patients with this syndrome (68%) compared to men with normal testosterone levels, but larger studies would be necessary to analyze and demonstrate this relationship.

What are the symptoms of male hypogonadism?

In addition to being part of preventive measures for cardiovascular health, testosterone deficiency can lead to other quality of life issues and should therefore be considered an important facet of diabetic patient care:

  • Testosterone deficiency syndrome often decreases sexual desire and the quality of erections.
  • It could also negatively influence various facets related to quality of life and, above all, the patients’ mood.
  • Affected individuals also exhibit decreased energy, irritability, depressed mood and decreased cognitive function, as well as poorer sleep quality.
  • Decreased lean body mass, increased visceral fat and reduced muscle mass and strength, as well as hair and skin thickness, are other signs that may hide a diagnosis of hypogonadism.
  • Hypogonadism is not the same as erectile dysfunction, although it may be behind the latter. For this reason, it is important that men with symptoms report it to their specialist.
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How can this pathology be treated?

It is important to check testosterone levels in men (mainly diabetics) over 40 years of age and, even more so, if they present associated symptoms such as erectile dysfunction, abdominal obesity, loss of muscle mass, insulin resistance, fatigue, depression or decreased libido.

The main treatment for this syndrome would be testosterone replacement therapy. This treatment should be prescribed by an endocrinologist once the diagnosis is established and the necessary control measures are taken.