Type 2 Diabetes—Studies Show Low Testosterone Increases Health Risks

Research into the role of testosterone in type 2 diabetes continues to capture the attention of scientists and make prominent appearances in the medical journals, and for good reason.

Cases of diabetes are increasing at an alarming rate in the United States. The CDC’s (Centers for Disease Control) 2017 National Diabetes Statistics Report states that cases of diabetes have risen to an estimated 30.3 million.

A middle-aged man with short gray hair and glasses tests his blood sugar by pricking his finger. Low testosterone may play a role in the development of type 2 diabetes.

The Negative Impact of Diabetes

The cost of diabetes to individuals and the nation as a whole is staggering. Consider these worrisome statistics from the same CDC report:

  • Diabetes was the seventh leading cause of death in the United States in 2015, listed as a possible cause of death on 252,806 death certificates in 2015
  • Average medical expenditures for people with diagnosed diabetes were about $13,700 per year, with $7,900 attributed directly to diabetes
  • Average medical expenditures for people with diagnosed diabetes were approximately 2.3 times higher than for people without diabetes
  • The total estimated cost of diagnosed diabetes in the U.S. was $245 billion in 2012

Not only an American problem, diabetes is a leading cause of disability worldwide.

Low Testosterone and the Development of Type 2 Diabetes

Men with type 2 diabetes tend to have lower testosterone levels and higher rates of chronic hypogonadism (the medical term for low testosterone) than other men, which indicates low testosterone levels may be a reversible risk factor for type 2 diabetes.

The collection of scientific evidence supporting this conclusion continues to grow.

A 2006 meta-analysis showed that men with healthy testosterone levels, in this study defined as greater than 15.6 nmol/L, are 42% less likely to develop type 2 diabetes compared to men with testosterone levels below 15.6 nmol/L.

An analysis of 13 different population studies that totalled 16,709 participants also showed similar results from the opposite angle—higher total and free testosterone levels significantly decrease the risk of type 2 diabetes in men by 38% and 23%. This study was methodologically sound and large enough to lend credibility to the suspected causal role low testosterone plays in the development of type 2 diabetes.

The researchers concluded:

“This meta-analysis suggests that higher testosterone levels can significantly decrease the risk of type 2 diabetes in men. Therefore, combined with previous research, the findings above suggest a reverse-causality scenario in the relation between testosterone deficiency and risk of type 2 diabetes in men.”

Further research, in this case a 14‐year follow‐up study that collected health record data of more than 500 men with type 2 diabetes to evaluate the influence of baseline testosterone levels on type 2 diabetes outcomes, found concerning results:

  • Lower baseline total testosterone levels were significantly associated with a higher BMI (Body Mass Index) and increased risk of stroke
  • The mortality rate was nearly twice as high in patients with lower total testosterone compared to normal baseline total testosterone
  • The age‐adjusted hazard ratio for higher mortality associated with low total testosterone corresponded to a reduced life expectancy of 3.2 years for men with both hypogonadism and type 2 diabetes, compared to men who only have type 2 diabetes

The researchers’ overall conclusion was that low testosterone levels are associated with higher all‐cause mortality in men with type 2 diabetes.

Testosterone Replacement May Provide Treatment Options

Men who have both hypogonadism and type 2 diabetes should be considered at risk for adverse health events.

Low testosterone, obesity, and type 2 diabetes form a preventable cycle of ill health that negatively impacts many men’s quality of life. The restoration of healthy testosterone levels through TRT (Testosterone Replacement Therapy) could be the first step in a return to better health.

For more information on the health benefits of TRT, we recommend reading our comprehensive guide, which contains facts and answers to the most common questions regarding the treatment of Low Testosterone.

Read the Guide



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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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