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Low Testosterone and Diabetes. Could TRT Help With Type 2 Diabetes?

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Low testosterone and diabetes, in particular type 2, are closely connected. Being overweight and carrying too much visceral fat are the most common causes of type 2 diabetes in men. Visceral fat typically develops from middle age onwards and is often caused by the natural decline in testosterone levels, unhealthy diet, and a lack of exercise. TRT can combat the undesirable symptoms of low testosterone levels, particularly those associated with type 2 diabetes.

What is Type 2 diabetes?

  • Type 2 diabetes is a common condition where blood sugar levels (glucose) become too high.
    Common symptoms include excessive thirst, needing to urinate frequently, and tiredness. It can also increase your risk of issues with the eyes, heart, and nerves, disrupting blood flow around the body, often causing erectile dysfunction.
  • Usually, a lifelong condition, type 2 diabetes, requires diet changes, daily medication, and regular check-ups.
  • Type 2 diabetes develops due to problems with a hormone called insulin. When you eat, your pancreas releases insulin, processing sugars in your blood converting them into energy. When this conversion becomes disrupted by insulin resistance, this process stops, causing blood sugar levels to spike.
  • Being overweight or obese increases the chances of developing type 2 diabetes. In this disease, the body makes enough insulin, but your cells have become resistant to it. Your body, therefore, can't use or store glucose for energy. Instead, the glucose stays in your blood.

How is Testosterone Linked with Type 2 Diabetes?

Testosterone is a steroid hormone that is often called the "male sex hormone," this is the hormone that gives men many of their male traits. There is a significant link between low testosterone and diabetes (Type 2) in men, with many studies 1 proving the association. In fact, up to a third of all people (including young people3) with type 2 diabetes are have hypogonadism, a condition where the testicles produce insufficient testosterone.

The link between lifestyle, low testosterone, and diabetes 2 is pretty straightforward, and both may contribute to impaired performance, mood, and libido. Countless other studies show that men with diabetes are likely to have low testosterone and vice-versa, but why is this?

Fat, The Main Cause of Type 2 Diabetes

Fat is one of the most common causes of low testosterone and diabetes (type 2). Testosterone, thyroid hormones, insulin, and cortisol significantly influence many bodily functions, from your appetite to sex drive and your metabolism's efficiency. In particular, they alter how fat distributes around your body. Fat is stored subcutaneously under the skin or internally around your organs (visceral fat). Hormones, in particular, testosterone, is negatively impacted by visceral fat, which reduces levels in the body.

Visceral fat produces an enzyme called aromatase. This enzyme has one unfortunate property, making it a hurdle for overweight men. Aromatase takes testosterone (which enables fat burning and muscle growth) and converts it into estradiol. Ultimately this conversion slows down testosterone production, and if you already have low testosterone, this further reduces this hormone in the body – making it much harder to lose weight.

What is Insulin Resistance?

Unlike type 1 diabetes which occurs when the pancreas cannot produce enough insulin, type 2 diabetes develops due to insulin resistance.

Insulin resistance usually occurs in people who are overweight, but not always. When your body doesn't respond to insulin as it should, you become insulin resistant. Problems then arise because the body starts producing more insulin which causes high blood pressure, hunger, and weight gain.

Studies show that you can increase the body's insulin sensitivity and counteract the problem by significantly reducing your added sugar and refined carbohydrate intake. However, a hormone imbalance, particularly one associated with stubborn visceral fat, becomes a roadblock that many find hard to overcome. 

What is Metabolic Syndrome?

There are many common symptoms of low testosterone and diabetes (type 2). The most important, visceral fat, is associated with many risk factors commonly grouped under the umbrella "metabolic syndrome." This group of conditions includes:

  1. Abdominal (visceral) obesity
  2. Hypertension (high blood pressure)
  3. Elevated triglycerides (high ''bad'' cholesterol)
  4. Low serum high-density lipoprotein (Low good cholesterol, HDL)
  5. Insulin resistance (leads to type 2 diabetes)

These conditions often cause cardiovascular disease, particularly insulin resistance, which causes type 2 diabetes. TRT and lifestyle changes effectively combat many of the symptoms of metabolic syndrome, including insulin resistance, cardiovascular disease, and type 2 diabetes. 6

Optimizing testosterone levels can help you lose weight and gain control of your insulin sensitivity. To find out if you could benefit from TRT, why not take our obligation-free, online assessment now?ƒ

Take FREE Hormone Assessment Now

What is Prediabetes? 

One of the most significant benefits of testosterone therapy is how it can reverse type 2 diabetes and stop diabetes from developing in the first place. The Center for Disease Control and Prevention, National Diabetes Statistics Report, 2020, states that 34.5% of adult Americans (88 million) have prediabetes 5.

Prediabetes is when your blood sugars are higher than they should be but not high enough to be diagnosed with type 2 diabetes. The raised blood sugar levels put you are at increased risk of developing type 2 diabetes. Often people with prediabetes have no symptoms.

The same factors cause prediabetes and diabetes, but you just haven't developed it fully yet. Studies 4 show that TRT can help stop prediabetes, and for both, the solution is the same – reduce visceral fat by administering testosterone, exercising, and improving your diet.

How Can TRT Help with Low Testosterone and Diabetes (Type 2)?

With a combination of testosterone therapy (TRT) and lifestyle changes, type 2 diabetes is controllable and, in some cases, reversible. TRT is an effective medication that can help stop prediabetes from becoming full-blown.

What are The Benefits of TRT?

  • Healthy heart and blood: improved cardiovascular health, reduced heart attack risk.
  • Less fat and more muscle: reduce potentially harmful visceral fat and diabetes risk.
  • Stronger bones: Reduced osteoporosis risk and risk of broken bones.
  • Healthier mind: Better verbal memory, spatial abilities, or mathematical reasoning: Reduced Alzheimer's disease risk.
  • Improved libido and sexual function: No need for expensive E.D. medications.
  • Improved mood: Reduced risk of depression.

"Studies with testosterone therapy suggest significant benefits in sexual function, quality of life, glycaemic control, anemia, bone density, fat, and lean muscle mass." Hackett G. Type 2 Diabetes and Testosterone Therapy. World J Men's Health. 2019 1

What Can You do to Avoid or Even Reverse Type 2 Diabetes?

  • TRT: Fat is the most significant cause of type 2 diabetes. Visceral fat, or the 'hormone belly' as it is also known, is usually to blame. By readjusting your hormone balance using TRT, studies show,7 you can ease many symptoms of type 2 diabetes. You will regain energy levels increase testosterone, fat burning, and muscle-building powers. Along with exercise and a healthy diet, it is possible to turn the tide and avoid type 2 diabetes and prediabetes altogether.
  • Regular exercise: Physically active Men often have higher testosterone levels than those who are sedentary. Therefore, your exercise routine should include not only aerobic exercise but also weightlifting. But be careful not to overdo it; studies 6 show overtraining can also cause adrenal fatigue and lower testosterone levels.
  • Healthy diet: Try to eat a balanced diet high in protein, fresh vegetables, and fruit. Also, by reducing your sugar intake, you will promote a healthy weight. A diet high in saturated fats and processed food will knock down testosterone levels and increase visceral and subcutaneous fat, the most significant cause of diabetes. Remember, visceral fat will reduce your testosterone levels, and significant weight loss will be much more challenging to achieve without the correct hormone balance.
  • Reduce stress levels: Stress is bad for you. It increases levels of a hormone called cortisol. The hormone directly pushes testosterone levels down. It also facilitates fat distribution straight to your abdomen (visceral fat), reducing testosterone and increasing estradiol from fat. Testosterone replacement therapy will help reduce cortisol levels and aid your ability to cope with stress.
  • Ensure you get enough vitamin D: In studies, vitamin D effectively increases testosterone levels in men, particularly if you are deficient. Vitamin D also improves insulin sensitivity – regulating blood sugar levels and reducing insulin resistance.
  • Check your thyroid function: Hormones produced in the thyroid are essential for regulating metabolism and controlling weight and cholesterol. Hypothyroidism (low thyroid) is when your thyroid doesn't produce enough thyroid hormone, slowing down metabolism. In conjunction with optimized testosterone levels, optimized thyroid hormones make losing weight, burning fat, and reversing insulin resistance easier.

TRT addresses the direct symptoms that cause type 2 diabetes to develop, namely being overweight and the development of visceral fat. But, crucially, TRT also can help deal with the motivation and energy required to do something about it.

(1) Hackett G. Type 2 Diabetes and Testosterone Therapy. World J Men'sMen's Health. 2019;37(1):31-44. doi:10.5534/wjmh.180027

(2) Grossmann M, Thomas MC, Panagiotopoulos S, Sharpe K, Macisaac RJ, Clarke S, Zajac JD, Jerums G. Low testosterone levels are common and associated with insulin resistance in men with diabetes. J Clin Endocrinol Metab. 2008 May;93(5):1834-40. doi: 10.1210/jc.2007-2177. Epub 2008 Mar 4. PMID: 18319314.

(3) University at Buffalo. (2008, August 30). Young Type-2 Diabetic Men Suffer Low Testosterone Levels, Study Shows. ScienceDaily. Retrieved March 1, 2022 from www.sciencedaily.com/releases/2008/08/080827163927.htm

(4) Yassin A, Haider A, Haider KS, Caliber M, Doros G, Saad F, Garvey WT. Testosterone Therapy in Men With Hypogonadism Prevents Progression From Prediabetes to Type 2 Diabetes: Eight-Year Data From a Registry Study. Diabetes Care. 2019 Jun;42(6):1104-1111. doi: 10.2337/dc18-2388. Epub 2019 Mar 12. PMID: 30862651.

(5) Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.


(6) Brooks K, Carter J. Overtraining, Exercise, and Adrenal Insufficiency. J Nov Physiother. 2013 Feb 16;3(125):11717. doi: 10.4172/2165-7025.1000125. PMID: 23667795.

(7) Jones TH, Arver S, Behre HM, Buvat J, Meuleman E, Moncada I, Morales AM, Volterrani M, Yellowlees A, Howell JD, Channer KS; TIMES2 Investigators. Testosterone replacement in hypogonadal men with type 2 diabetes and/or metabolic syndrome (the TIMES2 study). Diabetes Care. 2011 Apr;34(4):828-37. doi: 10.2337/dc10-1233. Epub 2011 Mar 8. PMID: 21386088; PMCID: PMC3064036.