title: Effect of testosterone treatment on glucose metabolism in men with type 2 diabetes: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether testosterone therapy improves glucose metabolism in men with type 2 diabetes (T2D) and lowered testosterone.
  
  
  METHODS
  We conducted a randomized, double-blind, parallel, placebo-controlled trial in 88 men with T2D, aged 35-70 years with an HbA1c ≤8.5% (69 mmol/mol), and a total testosterone level, measured by immunoassay, of ≤12.0 nmol/L (346 ng/dL). Participants were randomly assigned to 40 weeks of intramuscular testosterone undecanoate (n = 45) or matching placebo (n = 43). All study subjects were included in the primary analysis. Seven men assigned to testosterone and six men receiving placebo did not complete the study. Main outcome measures were insulin resistance by homeostatic model assessment (HOMA-IR, primary outcome) and glycemic control by HbA1c (secondary outcome).
  
  
  RESULTS
  Testosterone therapy did not improve insulin resistance (mean adjusted difference [MAD] for HOMA-IR compared with placebo -0.08 [95% CI -0.31 to 0.47; P = 0.23]) or glycemic control (MAD HbA1c 0.36% [0.0-0.7]; P = 0.05), despite a decrease in fat mass (MAD -2.38 kg [-3.10 to -1.66]; P < 0.001) and an increase in lean mass (MAD 2.08 kg [1.52-2.64]; P < 0.001). Testosterone therapy reduced subcutaneous (MAD -320 cm(3) [-477 to -163]; P < 0.001) but not visceral abdominal adipose tissue (MAD 140 cm(3) [-89 to 369]; P = 0.90).
  
  
  CONCLUSIONS
  Testosterone therapy does not improve glucose metabolism or visceral adiposity in obese men with moderately controlled T2D and modest reductions in circulating testosterone levels typical for men with T2D.
authors.affiliation: Department of Medicine Austin Health, University of Melbourne, Heidelberg, AustraliaDepartment of Endocrinology, Austin Health, Heidelberg, Australia.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Gianatti
authors.affiliation: Department of Medicine Austin Health, University of Melbourne, Heidelberg, AustraliaDepartment of Endocrinology, Austin Health, Heidelberg, Australia.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dupuis
authors.affiliation: Department of Medicine Austin Health, University of Melbourne, Heidelberg, Australia.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Hoermann
authors.affiliation: Department of Medicine, Southern Clinical School, Monash University, Clayton, Australia.
authors.forename: Boyd J
authors.initials: BJ
authors.lastname: Strauss
authors.affiliation: Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Wentworth
authors.affiliation: Department of Medicine Austin Health, University of Melbourne, Heidelberg, AustraliaDepartment of Endocrinology, Austin Health, Heidelberg, Australia.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Zajac
authors.affiliation: Department of Medicine Austin Health, University of Melbourne, Heidelberg, AustraliaDepartment of Endocrinology, Austin Health, Heidelberg, Australia mathisg@unimelb.edu.au.
authors.forename: Mathis
authors.initials: M
authors.lastname: Grossmann
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D000328:Adult; D000368:Aged; D000728:Androgens / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism*; D050260:Carbohydrate Metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism
chemical_list: D000728:Androgens; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D013739:Testosterone; C010792:testosterone undecanoate