The positive metabolic and antioxidative properties of the testosterone replacement therapy at the combination of the type 2 diabetes mellitus and the hypogonadism

The treatment of type 2 diabetes mellitus (T2DM) is multifactorial because the complex metabolic targets. The recent approach to T2DM management is associated with the male hypogonadism correction using the testosterone replacement treatment (TRT), the hormone with metabolic and antioxidant effects.

Aim - to assume the antioxidant and metabolic TRT-effects at T2DM patients with visceral obesity and male hypogonadism. Purpose: the assessment of efficiency and safety of TRT at the patients with T2DM and male hypogonadism.

Material and methods. In the randomized (1:1) observational clinical trial 124 males with T2DM and androgen deficiency were included. Patients from the main group were treated with «Androgel» (10 mg/day cutaneous). The control group was without TRT. Before and after 12 months TRT it was assumed the dynamics of the following parameters: glycosylated hemoglobin HbA1c, triglycerides TG, total cholesterol T-CHOl, lipoproteins high density lPHD, lipoproteins low density lPlD, Atherogenic Index AI, and oxidative status parameters (superoxide dysmutase SOD, glutationperoxidase GPO, Index of the oxidative stress dynamics ΔOxS. The safety parameters (PSA and prostate volume Vpr) also were studied. The statistical handling was made with Statistica 6.0.

Results. If TRT took place, it was the positive dynamics of HbA1c, TG, T-CHOl, lPHD, lPlD, AI. During 12 months TRT the between-group differences were -0.8%, -0.21, -0.16, 0.08, -0.26 mmol/l and -0,6U accordantly (p<0.05). At the main group the testosterone increasing from 9.2±1.8 to 15.4±2.1 pmol/l is associated with the increasing: SOD (from 175.1±13.0 to 199.0±11.0 U/ml), GPO (from 5256.8±778.9 to 6589.3±734.2 U/l), ΔOxS (from 1.0 to 1.17) (p<0.05). PSA and Vpr don't elevated (p>0.05).

Conclusions. The correction of the androgen deficiency at the at the patients with T2DM, visceral obesity and male hypogonadism using TRT can help for safe and efficient improvement of metabolic parameters, elimination of glucolipotoxicity, and enhancement of the antioxidant status.