1492 TESTOSTERONE REPLACEMENT THERAPY IMPROVES GLUCOSE CONTROL THROUGH WEIGHT LOSS AND WAIST CIRCUMFERENCE REDUCTION

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy1 Apr 20121492 TESTOSTERONE REPLACEMENT THERAPY IMPROVES GLUCOSE CONTROL THROUGH WEIGHT LOSS AND WAIST CIRCUMFERENCE REDUCTION James Kashanian, Youssef El Douaihy, Propa Gosh, Kuldeep Rawat, Aksam Yassin, and Ridwan Shabsigh James KashanianJames Kashanian Brooklyn, NY More articles by this author , Youssef El DouaihyYoussef El Douaihy Brooklyn, NY More articles by this author , Propa GoshPropa Gosh Brooklyn, NY More articles by this author , Kuldeep RawatKuldeep Rawat Brooklyn, NY More articles by this author , Aksam YassinAksam Yassin Hamburg, Germany More articles by this author , and Ridwan ShabsighRidwan Shabsigh Brooklyn, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2014AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Physiologic testosterone increases lean body mass and decreases adipose tissue. We hypothesized that long-term testosterone replacement in patients with late onset hypogonadism (LOH) improves insulin resistance secondary to decreasing weight and central obesity. METHODS As of November 2004, 64 diabetic patients diagnosed with LOH were recruited in 3 centers in Germany for long-term testosterone replacement therapy. Long acting Testosterone Undecanoate (TU) 1000mg was given at day 1, then 6 weeks post diagnosis of LOH and every 3 months thereafter. The mean follow up time was 4.25 years. Demographic data including weight (W) and waist circumference (WC) was collected during the first visit and at every follow up visit (T). Fasting glucose and HbA1c were captured at every T. Assessment of the effect of WC and W loss were conducted separately. At the first stage, the cohort was stratified into 2 groups: patients who lost >5% of their W during the study, and those who gained or did not lose 5% of their initial body weight. T- test was used to compare glucose and HbA1c at every visit. Similarly the analysis was conducted on the cohort stratified by central obesity: those who had decreased or maintained their WC <102 cm vs those who had >102 cm WC at their last visit. Graphs were generated to plot the means of glucose and HbA1c vs. time to compare between patients subgroups. RESULTS Both glucose and HbA1c means decreased from 150.1±5.3 to 95.4±4.8 and from 8.5±2.1 to 5.9±1.5 respectively over 60 months in all 64 patients. T-tests showed significantly lower means of glucose and HbA1c at more than half of the visits in patients who lost W. In addition; when we compared patients who reduced their WC or maintained <102cm to patients who had a WC of 102, we found that the former also had significantly lower means of fasting glucose and HbA1C. Graph 1 shows the curves of the means of HbA1c in the patients who had increased WC and those who had a WC>102cm at their last visit. Fasting glucose and HbA1c curves were similar in the stratification by W loss analysis. CONCLUSIONS Insulin resistance improves with the administration of TU. This improvement is statistically higher in patients who manage to lose weight and waist circumference. This finding suggests that testosterone replacement might have an indirect effect on improving DM control. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e604 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Kashanian Brooklyn, NY More articles by this author Youssef El Douaihy Brooklyn, NY More articles by this author Propa Gosh Brooklyn, NY More articles by this author Kuldeep Rawat Brooklyn, NY More articles by this author Aksam Yassin Hamburg, Germany More articles by this author Ridwan Shabsigh Brooklyn, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...