Therapeutic Testosterone Therapy May Reduce the Risk of Type-2 Diabetes in Low-T Patients

Written by Dr. Chris Smith, Updated on December 16th, 2023
Reading Time: 3 minutes

The rising prevalence of Type-2 Diabetes is one of the most pressing health concerns of the 21st Century. Researchers worldwide continue to explore a range of treatment options and continue to learn more about how to reduce the risk of diabetes in at-risk populations.

A team of scientists in Australia believes that Bio-Identical Testosterone Treatments may help men with Low-T avoid a future Type-2 Diabetes Diagnosis.

Which Came First? Testosterone Deficiency or Insulin Resistance?

It's often the case that certain medical conditions create negative feedback loops with one another. This loop increases the risk for correlated disorders and increases the severity of other related health issues.

There is a wealth of good research indicating that obesity heightens the risk of both Type-2 Diabetes and Testosterone Deficiency. It's also true that Low-T increases the risk of Insulin Resistance even in patients at a relatively healthy weight.

Currently, lifestyle management is the primary means to reduce the risk of Type-2 Diabetes in patients that are obese.

While diet and exercise programs improve outcomes for patients at high risk of diabetes, it's critical to explore other options. Dr. Gary Wittert and his associates designed a study to examine the potential of Testosterone Replacement Therapy as a useful means to reduce the risk of diabetes.

Furthermore, they were interested in testing whether Low-T Shots could reverse early Type-2 Diabetes.

Determining the Potential Benefits of Low-T Treatment for insulin-resistant Patients

Researchers worked with 1007 patients for two years to provide the data for the Low-T/Diabetes Study. Patients ranged in age from 50 to 74. The design was double-blind and randomized, with control patients receiving placebo injections.

All participants also participated in WW (Weight Watchers) as a community-guided effort to encourage a healthy lifestyle.

Men were selected for this study based on three factors:

  • Testosterone Levels Below 14 nmol/L (of non-pathological origin)
  • Notable Insulin Resistance and/or recent diagnosis of Type-2 Diabetes
  • Waistline over 95 cm

This Australian Diabetes/Testosterone Deficiency Study was conducted from 2013-2017. Experimental patients received 1000mg doses of Testosterone Undecanoate, and controls received Placebo. Injections were delivered on day one, after six weeks, then on 3-month intervals over the next two years.

In order to determine the effectiveness of treatment, researchers measured results by comparing baseline glucose tolerance to change over time.

Results of Testosterone Therapy for Patients with Insulin Resistance

After the study was complete, the results were compiled and analyzed. Researchers discovered that patients taking Testosterone Therapy fared better than placebo patients. Among those taking Placebo, 21% had elevated glucose levels (at or above 11.1 mmol). Only 12% of experimental patients exceeded this threshold. The average improvement in glucose scores for placebo patients was -0.95 mmol, while patients receiving Testosterone saw a net-change of -1.7 mmol/L as compared to baseline.

Dr. Wittert believes that Testosterone Therapy was effective at combating Insulin Resistance because it positively affected body composition. He is confident that a reduction in body fat improved Insulin Sensitivity and that increased lean muscle was another possible contributing factor.

While the results were promising, future studies will be needed to further assess the safety and potential risks associated with the use of Testosterone to improve Insulin Sensitivity.

22% of Testosterone Patients ended up with Hematocrit Levels over the safety threshold set by the study (54% increase from baseline), significantly higher than the 1% of Placebo Patients that passed that mark. Researchers believe that elevated Hematocrit Levels may prevent some patients from benefiting safely from this treatment.

Patients were also removed from the study if PSA Levels increased by more than 0.75 g/mL. In this case, however, results were similar for both groups (19% on Placebo vs. 23% on Testosterone).


The Lancet Diabetes & Endocrinology. "Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle program (T4DM): a randomized, double-blind, placebo-controlled, 2-year, phase 3b trial"

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