The use of testosterone replacement therapy for the treatment of adult males with type 2 diabetes and hypogonadism: a meta-analysis of randomised controlled trials

Abstract

Despite varying findings, TST has been used for a long time to treat hypogonadal males with type 2 diabetes mellitus (T2DM). The function of TST was evaluated in this meta-analysis in hypogonadal males with type 2 diabetes. Relevant randomised controlled trials and observational studies were identified by searching PubMed, Embase, and Google Scholar. The effects of TST were evaluated using pooled mean differences (MDs) and relative risks with 95% confidence intervals (CIs).Our meta-analysis includes 3,002 hypogonadal, type 2 diabetics from 13 randomised controlled trials and 2 observational studies. Total testosterone levels increase significantly with testosterone replacement, and TST significantly improves glycemic management compared to placebo by lowering homeostatic model assessment of insulin resistance (WMD = -1.47 [-3.14, 0.19]; p=0.08; I2=56.3%), fasting glucose (WMD = -0.30 [-0.75, 0.15]; p=0.19; I2= 84.4%), fasting insulin (WMD = -2.95 [-8. Overall, TST resulted in a greater increase in free testosterone levels compared to placebo (WMD = 81.21 [23.87, 138.54] p=0.07; I2= 70%) when comparing patients' individual measurements.We conclude that TST can help hypogonadal Type 2 Diabetes patients with better glycemic control and hormone levels, as well as lower total cholesterol, triglyceride, and LDL cholesterol while raising HDL cholesterol. Therefore, in addition to the usual care for diabetes, we advise TST for these individuals.