Background:While previous studies have demonstrated testosterone's beneficial effects on glycemic control in men with hypogonadism and Type 2 Diabetes, the extent to which these improvements are observed based on the degree of treatment adherence has been unclear.Objectives: To evaluate the effects of long-term testosterone therapy in A1C levels in men with Type 2 Diabetes Mellitus and hypogonadism, controlling for BMI, pretreatment A1C, and age among different testosterone therapy adherence groups. Materials and methods:We performed a retrospective analysis of 1737 men with diabetes and hypogonadism on testosterone therapy for 5 years of data from 2008-2018, isolating A1C, lipid panels, and BMI results for analysis. Subjects were categorized into adherence groups based on quartiles of the proportion of days covered (> 75% of days, 51-75% of days, 26-50% of days and 0-25% of days), with >75% of days covered considered adherent to therapy.Results: Pre-treatment median A1C was 6.8%. Post-treatment median A1C was 7.1%.The adherent group, >75%, was the only group notable for a decrease in A1C, with a median decrease of −0.2 (p = 0.0022). BMI improvement was associated with improved post-treatment A1C (p = 0.007). When controlling for BMI, age, and pre-treatment A1C, the >75% adherence group was associated with improved post-treatment A1C (p < 0.001). Discussion:When controlling for all studied variables, testosterone adherence was associated with improved post-treatment A1C. The higher the initial A1C at the initiation of therapy, the higher the potential for lowering the patient's A1C with >75% adherence. Further, all groups showed some reduction in BMI, which may indicate that testosterone therapy may affect A1C independent of weight loss. Conclusion:Even when controlling for improved BMI, pre-treatment A1C, and age, testosterone positively impacted glycemic control in diabetes patients with hypogonadism, with the most benefit noted in those most adherent to therapy (>75%).

We conducted an expert survey of leprosy (Hansen’s Disease) and neglected tropical disease experts in February 2016. Experts were asked to forecast the next year of reported cases for the world, for the top three countries, and for selected states and territories of India. A total of 103 respondents answered at least one forecasting question. We elicited lower and upper confidence bounds. Comparing these results to regression and exponential smoothing, we found no evidence that any forecasting method outperformed the others. We found evidence that experts who believed it was more likely to achieve global interruption of transmission goals and disability reduction goals had higher error scores for India and Indonesia, but lower for Brazil. Even for a disease whose epidemiology changes on a slow time scale, forecasting exercises such as we conducted are simple and practical. We believe they can be used on a routine basis in public health.

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Approximately 25% of men with type 2 diabetes mellitus (T2DM) have hypogonadotropic hypogonadism. Although there is a paucity of trials evaluating testosterone therapy in relation to T2DM, there have been recent studies highlighting possible additional benefits of its use in men with T2DM. Our study aims to evaluate the effects of long-term testosterone therapy on A1c in men with co-occurring T2DM. We identified 12,125 military beneficiaries with dual diagnoses of T2DM and hypogonadism from 2005-2018. Roughly 10.5% (1,125) met inclusion criteria: testosterone treatment ≥5 years and available pre-treatment and post-treatment clinical values (A1c, serum testosterone, and BMI). Patients were categorized as follows based on testosterone adherence rates: Group 1 (≥75%; n=72), Group 2 (50-74%; n=172), Group 3 (25-49%, n=266), Group 4 (&lt;25%; n=762). All groups showed improvement in BMI over time, although it was more substantial in Group 1. Pre- and post-treatment BMI values were 33.7 kg/m2 vs. 32.8 kg/m2 for Group 1 (-0.93 kg/m2), 33.7 kg/m2 vs. 33.5 kg/m2 for Group 2 (-0.2 kg/m2), 34.1 kg/m2 vs. 33.8 kg/m2 for Group 3 (-0.3 kg/m2), 33.8 kg/m2 vs. 33.4 kg/m2 for Group 4 (-0.4 kg/m2). Pre- and post-treatment A1c values were 6.8% vs. 6.6% for Group 1 (-0.18%), 7% vs. 7.1% for Group 2 (+0.11%), 7% vs. 7.3% in Group 3 (+0.3%), and 7.4% vs. 7.6% in Group 4 (+0.25%). Thus, the A1c improvement in Group 1 was statistically significant when compared to Group 3 (p=0.045) and Group 4 (p=0.047). Despite improvement in BMI for all groups, only Group 1 showed improvement in A1c. This speaks to the potential effect of testosterone on A1c specifically, irrespective of BMI, as evidenced by the glycemic benefit only seen in those with the highest adherence rates. Disclosure C. Jenkins: None. J.M. Tate: None. J.L. Wardian: None. A. Rittel: None. I. Folaron: None.