Journal of Andrology Testis Workshop 2009
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Published-Ahead-of-Print September 4, 2008, DOI:10.2164/jandrol.108.005751

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The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes & Insulin Resistance

Abdulmaged M Traish *, Farid Saad , and Andre T Guay

* To whom correspondence should be addressed. E-mail: atraish{at}bu.edu.

A considerable body of evidence exists suggesting a link between reduced testosterone plasma levels, type 2 diabetes (T2D) and insulin resistance (IR). Hypogonadal men are at higher risk for type-2 diabetes. Here we evaluate the relationships between testosterone, metabolic syndrome (MetS), T2D, and IR and discuss the relationships between androgen deficiency and these factors, especially as it ultimately relates to the development of cardiovascular disease (CVD) and erectile dysfunction (ED). Thus, a comprehensive literature search was carried out using PubMed and relevant articles pertinent to androgen deficiency, T2D, IR, MetS, and ED were reviewed and discussed. Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin A1c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates IR and glycemic control, strengthening the link between testosterone deficiency and onset of type-2 diabetes and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose and Hemoglobin A1c levels. We suggest that androgen deficiency is associated with IR, T2D and MetS, and increased visceral fat deposition, which serves as an endocrine organ, producing inflammatory cytokines thus promoting endothelial dysfunction and vascular disease.


Key words: Androgen • Andropause • Erectile Dysfunction • Hormone • Penis • Androgen deficiency • Insulin resistance • Metabolic syndrome • Type 2 diabetes • vascular disease




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