Long-term testosterone use confers weight loss benefits among hypogonadal men with T2D
Long-term treatment with testosterone undecanoate (TU) in hypogonadal men with type 2 diabetes (T2D) resulted in substantial and sustained weight loss compared with untreated individuals, according to registry studies presented at the IDF 2017.
One registry study recorded 10-year results from 776 men with a mean testosterone level of ≤12.1 nmol/L, 286 of whom were diagnosed with T2D. Of these, 133 received TU 1000 mg/12 weeks, while 153 declined treatment and served as controls. A majority of the participants were obese (91 percent and 72 percent in the testosterone and control groups, respectively). [IDF 2017, abstract P-0300]
At 10 years, almost all participants in the testosterone group lost weight (132 out of 133), translating to a progressive decrease in mean weight (from 113.1 to 89.6 kg; p<0.0001), waist circumference (from 111.1 to 99.2 cm; p<0.0001), and body mass index (BMI, from 36.2 to 29.1 kg/m2; p<0.0001).
On the other hand, despite the weight gain observed among almost all participants in the control arm (136 out of 153), stable measurements were noted in terms of mean weight (from 100.8 to 99.2 kg) and BMI (from 32.3 to 32.7 kg/m2) at 10 years. There was a slight decrease in mean waist circumference in the last 4 years among participants in the control arm (from 115.1 to 111.8 cm).
The estimated adjusted difference between the two groups was significant in terms of mean weight (-22.2 kg; p<0.0001), waist circumference (-13.5 cm; p<0.0001), and BMI (-7.2 kg/m2; p<0.0001).
Weight loss benefit extends beyond 10 years
Twelve-year data from another registry study support these findings, showing significant weight reduction among testosterone recipients (mean weight from 107.8 to 86.6 kg; p<0.0001, waist circumference from 114.0 to 94.5 cm; p<0.0001, and BMI from 34.1 to 27.3 kg/m2; p<0.0001) vs untreated individuals with weight-related parameters that increased at 8 years (weight from 95.8 to 99.5 kg, waist circumference from 103.2 to 105 cm, and BMI from 30.5 to 32.3 kg/m2). [IDF 2017, abstract P-0330]
This study evaluated 505 hypogonadal men, 146 of whom had T2D (n=94 and 52 in the testosterone treatment and control groups, respectively). Nearly half of participants in both groups were classified as class I obese (42.6 percent and 41.5 percent, respectively).
Treating hypogonadism is important
Overall, both studies showed the potential of long-term testosterone treatment in facilitating weight loss among hypogonadal men with T2D.
“Hypogonadism [and obesity are] highly prevalent in men with [T2D] … and can affect half of patients with either condition … Correcting hypogonadism in men with T2D supports standard diabetes treatment including lifestyle instructions,” said researchers of the first study, commenting on the importance of these findings.
Investigators of the second registry study concurred, stating that “diagnosing and treating hypogonadism seems important to improve [T2D]-related parameters in hypogonadal men, in addition to standard therapy, thereby potentially reducing cardiometabolic risk.”
Although both studies had long follow-up durations and included participants who had excellent adherence to testosterone, the researchers pointed out that these were not randomized nor designed to evaluate the effects of testosterone on obesity in men with T2D.