Remission of type 2 diabetes and pleiotropic effects of long-term testosterone treatment for “late-onset” hypogonadism: A case report

[madman]

Abstract For obese type 2 diabetes patients, weight reduction is one of the most important measures but fails in most cases. Testosterone deficiency can be the reason for such failure. This case presents a 57-year-old man who was referred to a urologist due to benign prostatic hyperplasia and erectile dysfunction. He had type 2 diabetes, was overweight, and had hypertension and dyslipidemia. The blood test revealed testosterone deficiency. Under testosterone therapy, the patient lost 10 kg; cardiometabolic parameters returned to normal and lower urinary tract symptoms disappeared; complete remission of diabetes was recorded. Overweight and obese patients with type 2 diabetes should be tested for hypogonadism and testosterone therapy, if indicated, be considered. These patients can considerably benefit from testosterone therapy in terms of sustainable weight loss and a clinically significant reduction of cardiometabolic risk factors including complete remission of diabetes.















In summary, we are confident that overweight and obese patients with hypogonadism and T2DM can benefit from TTh. The benefits may be mediated by sustained weight loss and changes in body composition, resulting in a significant reduction of cardiometabolic risk factors including remission of T2DM. These improvements may lead to enhanced quality of life in patients suffering from the frequent combination of obesity, metabolic syndrome, T2DM, and cardiovascular disease together with a simultaneous reduction of healthcare costs. Controlled, randomized studies are needed for further confirmation of the findings shown in this case presentation.

 

[dnfuss]

Abstract For obese type 2 diabetes patients, weight reduction is one of the most important measures but fails in most cases. Testosterone deficiency can be the reason for such failure. This case presents a 57-year-old man who was referred to a urologist due to benign prostatic hyperplasia and erectile dysfunction. He had type 2 diabetes, was overweight, and had hypertension and dyslipidemia. The blood test revealed testosterone deficiency. Under testosterone therapy, the patient lost 10 kg; cardiometabolic parameters returned to normal and lower urinary tract symptoms disappeared; complete remission of diabetes was recorded. Overweight and obese patients with type 2 diabetes should be tested for hypogonadism and testosterone therapy, if indicated, be considered. These patients can considerably benefit from testosterone therapy in terms of sustainable weight loss and a clinically significant reduction of cardiometabolic risk factors including complete remission of diabetes.















In summary, we are confident that overweight and obese patients with hypogonadism and T2DM can benefit from TTh. The benefits may be mediated by sustained weight loss and changes in body composition, resulting in a significant reduction of cardiometabolic risk factors including remission of T2DM. These improvements may lead to enhanced quality of life in patients suffering from the frequent combination of obesity, metabolic syndrome, T2DM, and cardiovascular disease together with a simultaneous reduction of healthcare costs. Controlled, randomized studies are needed for further confirmation of the findings shown in this case presentation.

Great case study; wish there were more like it and some RCTs (not holding my breath). But FWIW, although the patient's HgbA1c and fasting glucose levels at the end of the study were greatly improved and under ADA standards would no longer indicate an unequivocal diagnosis of diabetes, they are not indicative of truly normal blood sugars. Rather, they would suggest a diagnosis of what is usually characterized as "pre-diabetes," i.e., mild diabetes. Completely agree that these are indeed very good results for this patient, just that I would hesitate to characterize it as clinically complete remission of diabetes.