Popular Diabetes Drug Decreases Testosterone in Men with Diabetes

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2012.04510.x/abstract
Effect of pioglitazone on testosterone in eugonadal men with type 2 diabetes mellitus: A randomized double blind placebo-controlled study
[h=3]Abstract[/b][h=4]Objectives[/b]Pioglitazone is an insulin sensitizer used for the management of type 2 diabetes mellitus (T2DM). It has been shown to reduce testosterone level in patients with polycystic ovarian syndrome. However, its effect on testosterone in men has not been studied.


[h=4]Research design and methods[/b]A randomized, double blind, placebo-controlled trial with six months follow-up. Fifty (25 in each group) eugonadal men (well virilized and total testosterone ≥ 12 nmol/L) with T2DM, aged 30-55 yr, and HbA1c of ≤ 7.5%, were randomly assigned to receive pioglitazone 30 mg per day or placebo along with existing glimepiride and metformin therapy.


[h=4]Results[/b]As compared to placebo, six months of pioglitazone therapy in patients with T2DM resulted in significant reduction in mean total testosterone level (16.1 to 14.9 vs 17.1 to 17.0 nmol/L; p = 0.031), calculated free testosterone (p = 0.001) and bioavailable testosterone (p = 0.000) despite significant increase in sex hormone binding globulin (p = 0.000). Plasma androstenedione (∆[SUP]4[/SUP]) level increased (1.5 to 1.9 ng/ml; p = 0.051) following pioglitazone therapy. The decrease in testosterone was independent of change in body weight, body fat, and HbA1c.


[h=4]Conclusion[/b]Pioglitazone therapy significantly decreases total, free and bioavailable testosterone in eugonadal men with T2DM. The effects of these alterations need to be determined by further long term studies.
 
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