Dr. Elyse Watkins
Purpose: The purpose of this article is to review the treatment of type 2 diabetes mellitus in obese men by inducing weight loss with the supplementation of testosterone replacement therapy.
Method: A PubMed literature search, and review was conducted with the terms: hypogonadism, testosterone replacement therapy, type 2 diabetes mellitus, obesity, and weight loss. The search yielded twenty-five related articles, and narrowed down to 10 for this literature review.
Results: More studies are necessary to determine the correlation of weight loss in obese men with type 2 diabetes mellitus with improved insulin sensitivity, and testosterone replacement therapy.
Conclusion: Obesity, metabolic syndrome, type 2 diabetes mellitus and male hypogonadism are complexly interrelated. Visceral adiposity pro-inflammatory cytokines, adipokines, free fatty acids, and estrogens that affect insulin sensitivity in fat, liver, and muscle tissue. It also affects endothelial functions that leads to vascular disease and hypertension. Prompt detection of low testosterone, which contributes to central obesity and accumulation of intra-abdominal fat, can also be a predictor for development of metabolic syndrome, and should be addressed to prevent worsening symptoms. Studies involving hypo-gonadal men with type 2 diabetes mellitus receiving testosterone replacement therapy, along with diet and exercise regimen have shown long-term improvement in glycemic control, body composition and weight loss1. The overall goal of these treatment plans should be weight reduction to improve metabolic homeostasis such as glycemic control, lipid levels, hematocrit, as well as improvement of hypo gonadal symptoms. Follow up with include monitoring for adverse effects such as prostate disease and cardiovascular disease. Further studies are required to determine the efficacy of the interventions.
Gonzalez C. Testosterone Replacement Therapy to aid in weight loss for male patients with Type 2 Diabetes Mellitus. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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