Aspects of testosterone replacement therapy in men with type 2 diabetes mellitus and testosterone deficiency

Abstract

Background. Testosterone deficiency is a medical condition that adversely affects male sexuality, reproduction, general health and quality of life. Testosterone therapy can improve the symptoms of testosterone deficiency and possibly stop the development of comorbid diseases. The purpose of the study is to determine the safety and side effects of substitution testosterone therapy in men with type 2 diabetes mellitus and testosterone deficiency. Materials and methods. Testosterone replacement therapy was carried out in 89 men aged 36–72 years with type 2 diabetes mellitus (duration from 1 to 18 years) and androgen deficiency: first group (35 patients) received testosterone undecanoate (1000 mg), second group (54 indivi­duals) — 1 ml of an oil solution (250 mg) of a mixture of testoste­rone esters. Results. In the examined patients of the first group, the average values of erythrocytes, hemoglobin and hematocrit after the end of the observation period did not change significantly. Mean prostate­specific antigen level 9 months after the initiation of testosterone therapy increased by less than 10 % of the baseline, from 1.48 ± 0.26 ng/ml to 1.62 ± 0.20 ng/ml (p > 0.05). An increase in the volume of the prostate gland was non­significant: 32.1 ± 1.9 cm³ before the start of treatment vs 35.7 ± 1.9 cm³ in 9 months. In men of the second group, the average rates of erythrocytes, hemoglobin and hematocrit after the completion of testosterone replacement therapy did not change significantly. The mean prostate­specific antigen values 9 months after the initiation of testosterone therapy in patients of the second group remained virtually unchanged: 1.22 ± 0.30 ng/ml prior to therapy and 1.24 ± 0.20 ng/ml 9 months after (p > 0.1). An increase in the prostate volume in the examined patients was non­significant: 28.4 ± 2.2 cm³ before the start of treatment vs 31.6 ± 1.6 cm³ in 9 months. Conclusions. The results showed that the use of testosterone with different duration of action in men with diabetes mellitus is an effective and safe method.