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Can Low Testosterone Cause Diabetes? (Backed by Science)

Connor Sellers
Published by Connor Sellers
Last updated: November 10, 2022

Diabetes is common in the United States, and so is low testosterone, and over many years as a fitness coach, I have had quite a few clients managing both, and they often wonder if the two are directly connected.

To better understand if low testosterone can cause diabetes, I dove into tens of hours of research, and I consulted with a medical colleague for additional insights.

Here is a quick read about diabetes and low testosterone.

Quick Summary

  • Low testosterone concentrations can cause insulin resistance, potentially leading to type 2 diabetes mellitus and poorer glycemic control.
  • Injectable testosterone undecanoate, an androgen used in testosterone replacement therapy, can improve glycemic control and insulin resistance.
  • Testosterone deficiency and diabetic complications include increased belly fat, but exercise and dietary changes can reduce it.

Does Low Testosterone Cause Diabetes?

A doctor testing a diabetic patient's blood

Low testosterone may cause Type 2 diabetes because it contributes to insulin resistance which can eventually lead to the onset of diabetes [1].

For Men

In combing through the studies, I noticed a bidirectional relationship between adipose tissue, particularly visceral fat, and testosterone levels. Increased visceral adiposity can lead to low testosterone levels, and low testosterone levels can lead to increased belly fat [2].

This relationship can create a vicious cycle that is hard to correct and ultimately result in decreased insulin sensitivity, which means higher insulin resistance and risk of developing type 2 diabetes [3].

One meta-analysis suggests that higher testosterone levels can significantly reduce the risk of type 2 diabetes and recognizes the significance of testosterone as protection against the onset of diabetes in men [4].

Additionally, another systematic review and meta-analysis recommend the efficacy of testosterone supplementation and testosterone replacement therapy in reducing the risk of diabetes in men with hypogonadism [5].

Additional Research

Low testosterone levels link to increased insulin resistance in men, but the opposite is true for women, where insulin resistance occurs with higher-than-normal testosterone levels [6].

Interestingly, a meta-analysis of the effects of hormone therapy on transgender individuals found that body composition improved, including decreased fat mass and increased muscle mass. Still, there was no effect on insulin resistance or incident diabetes risk [7].

What is Type 2 Diabetes?

A person testing for diabetes

Type 2 diabetes is a condition that occurs when the pancreas does not produce enough insulin to overcome insulin resistance and keep the blood sugar levels in a normal range [8].

Insulin is a hormone that promotes glucose uptake from the blood by the cells, among other important functions [9].

Your doctor can determine if you have type 2 diabetes by a blood test which may include one or more of the following:

  • Hemoglobin A1C test: measures average blood glucose levels in the previous three months.
  • Fasting glucose test: measures how much glucose is in your plasma, and you generally fast for at least eight hours before the test.
  • Oral glucose tolerance test: measure how well your body deals with glucose. A blood draw occurs before you drink glucose, then after an hour, and then again at two hours.

Insulin resistance is when the sugar uptake by the cells happens much slower and occurs when your body cannot adequately respond to insulin, primarily due to a reduced number of insulin receptors, but also various other reasons.

Glycemic control is the management of blood sugar levels, which is crucial for those with diabetes.

Can Having Low Testosterone Raise or Lower Your Blood Sugar Levels?

Low testosterone will likely raise your blood sugar levels because it plays a role in the signaling pathways related to sugar uptake by the cells [10].

So, for example, in men with low testosterone, blood sugar levels will likely remain elevated longer after eating a meal.

“Regular exercise, sufficient sleep, minimizing stress, losing excess fat, and eating a healthy, varied diet may help raise testosterone levels”

- Ryan Raman, MS, RD

Can I Take Testosterone if I Have Diabetes?

A doctor holding a syringe for testosterone

You may be able to take testosterone boosters if you have diabetes, but it is best to consult with your doctor to weigh the benefits and risks of testosterone replacement therapy.

Studies support testosterone therapy for hypogonadal men with type 2 diabetes [11].

Results show increased insulin sensitivity, better glycemic control, reduced belly fat, and reduced hypercholesterolemia (high cholesterol) with TRT.

Treating Low T and Blood Sugar Levels

A doctor taking care of a patient with low blood sugar levels

Men with type 2 diabetes should consult their doctor if they are experiencing the symptoms and signs of low testosterone [12].

They include:

  • Low sex drive
  • Erectile dysfunction
  • Hot flashes
  • Hair loss
  • Fatigue
  • Reduced lean body mass
  • Increased body fat
  • Decreased bone mass
  • Testicular shrinkage
  • Mood changes
  • Cognitive difficulties

Your doctor may think testosterone replacement therapy will benefit your low testosterone and type 2 diabetes. Be sure to discuss any risks of TRT and how it may impact your current diabetes management [13].

Risks include:

  • Sleep apnea
  • Acne
  • Benign prostatic hyperplasia
  • Growth of existing prostate cancer
  • Enlarged breasts
  • Reduced sperm production
  • Testicular shrinkage
  • Excessive blood cell production
  • Blood clots

Both testosterone and diabetes benefit from regular exercise and healthy dietary changes because both reduce the risk of obesity.

Obese men have reduced levels of sex hormone-binding globulin (SHBG), a protein that carries testosterone in the blood [14].

TRT and Diabetes

A doctor holding up a small medical book

A review published by the World Journal of Men’s Health notes that low testosterone is seen frequently in men with diabetes.

Studies find that androgen replacement therapy significantly benefits sexual function, quality of life, glycemic control, fat loss, and increased lean muscle and bone mass in men with type 2 diabetes [15].

The review also recognizes that the most benefit occurs when using testosterone replacement treatment in conjunction with lifestyle changes like exercise and dietary adjustments.

FAQs

What Happens if Low Testosterone Goes Untreated?

When low testosterone goes untreated, it can lead to loss of bone density, sexual dysfunction, increased cardiovascular risk, low sperm count, and loss of muscle strength, to name a few.

How Long Does It Take to Fix Low Testosterone?

It may take four to six weeks to fix low testosterone with testosterone therapy. Users report the same time frame for seeing results when taking a natural testosterone treatment/supplement.

Can Testosterone Cure Diabetes?

Testosterone probably cannot cure diabetes by itself, but emerging research shows that testosterone therapy could improve obesity, insulin resistance, and glycemic control, which means it may put Type 2 diabetes into remission [16].

So, Does Low Testosterone Cause Diabetes?

My research has shown me that there’s a clear connection between low testosterone, insulin resistance, and type 2 diabetes in men, but I wouldn't say there’s a direct causality.

However, I have seen remarkable results in my clients managing diabetes who are taking an all-natural testosterone booster.

They took the top testosterone boosters for men that helped them hit their goals in body composition and sexual function, improved energy levels, and vastly improved their quality of life.

We tested many products on the market to come up with this list, so make sure to check it out.


References:

  1. https://www.buffalo.edu/ubnow/stories/2020/08/dandona-testosterone-diabetes.html#
  2. https://www.army.mil/article/188893/belly_fat_in_men_what_you_can_do_to_reduce_it#
  3. https://www.medicalnewstoday.com/articles/323027#_noHeaderPrefixedContent
  4. https://pubmed.ncbi.nlm.nih.gov/29233816/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793809/
  6. https://academic.oup.com/jcem/article/94/12/4776/2596564
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061235/
  8. https://www.healthline.com/health/type-2-diabetes 
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227239/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834245/
  11. https://eje.bioscientifica.com/view/journals/eje/154/6/1540899.xml
  12. https://www.healthline.com/health/low-testosterone/warning-signs
  13. https://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/testosterone-therapy/art-20045728
  14. https://medlineplus.gov/lab-tests/shbg-blood-test/#:
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305869/
  16. https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.14122
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