title: Effects of long-term testosterone replacement therapy, with a temporary intermission, on glycemic control of nine hypogonadal men with type 1 diabetes mellitus - a series of case reports.
abstract: Type 2 diabetes mellitus (T2DM) is often associated with obesity and subnormal serum testosterone (T) levels. Until 5 years ago there was no indication that men with type 1 diabetes mellitus (T1DM) had subnormal serum T. But recent studies indicate that about 10% of men with T1DM suffer from hypogonadism, as a rule aged men and men with obesity. While hypogonadal men with T2DM benefit from normalization of their serum T, this has not been investigated in men with T1DM. Nine men with T1DM, erectile dysfunction and hypogonadism (total testosterone ≤ 12 nmol/L) received testosterone replacement therapy (TRT). In seven men TRT was intermitted: one man with prostate malignancy and six men because of problems of reimbursement. Incidentally, this provided an opportunity to monitor the effects of withdrawal and of the reinstatement of TRT. In all men, glycemic control (serum glucose and HbA1c), weight, waist circumference, lipid profiles and erectile function improved upon TRT. The seven men whose TRT was intermitted showed a deterioration which improved again upon reinstatement of TRT. The data suggest that aging and obese men with T1DM might have subnormal T levels and that their glycemic control, lipid profiles and erectile function might benefit from TRT.
authors.affiliation: a Global Medical Affairs Men's Healthcare, Bayer Pharma AG , Berlin , Germany .
authors.forename: Farid
authors.initials: F
authors.lastname: Saad
authors.affiliation: b Institute of Urology and Andrology, Segeberger Kliniken , Norderstedt , Germany .
authors.forename: Aksam
authors.initials: A
authors.lastname: Yassin
authors.affiliation: b Institute of Urology and Andrology, Segeberger Kliniken , Norderstedt , Germany .
authors.forename: Yousef
authors.initials: Y
authors.lastname: Almehmadi
authors.affiliation: c Department of Epidemiology and Statistics , Boston University School of Public Health , Boston , MA , USA , and.
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Doros
authors.affiliation: d Department of Internal Medicine , Endocrine Section, VU Medical Center , Amsterdam , The Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Gooren
mesh_terms: D000368:Aged; D000728:Androgens / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D038321:Glycemic Index; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D013739:Testosterone / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D001786:Blood Glucose; D013739:Testosterone
keywords: Diabetes mellitus type 1; HbA1c; erectile function; glucose; hypogonadism; testosterone; waist circumference