Testosterone treatment in men with type 2 diabetes and hypogonadotropic hypogonadism (HH) increased insulin sensitivity and lean mass, and decreased subcutaneous fat in a randomized placebo controlled trial involving 94 men.

Among the participants, 50 were eugonadal, and 44 had HH. Investigators calculated insulin sensitivity, and measured lean body mass and fat mass using DEXA and MRI. They took subcutaneous fat samples to analyze insulin-signaling genes. Those with HH were randomized to 250 mg of intramuscular testosterone or placebo every 2 weeks for 24 weeks.

Among the results:

• Men with HH had higher subcutaneous and visceral fat mass than eugonadal men.

• Insulin sensitivity was 36% lower in men with HH.

• Insulin sensitivity increased by 32% after 24 weeks of testosterone therapy vs no change after placebo.

• Testosterone treatment led to an average 3.3 kg decrease in subcutaneous fat mass and an average 3.4 kg increase in lean mass.

• Insulin signaling gene expression was significantly lower in men with HH and was upregulated after testosterone treatment.

Citation: Dhindsa S, Ghanim H, Batra M, et al. Insulin resistance and inflammation in hypogonadotropic hypogonadism and their reduction after testosterone replacement in men with type 2 diabetes. [Published online ahead of print November 29, 2015]. Diabetes Care. doi:10.2337/dc15-1518.