Testosterone Deficiencies Can Increase Death in Men with Diabetes

Allowing low testosterone levels to go untreated may sharply increase the risk of early death among men with Type 2 diabetes....

This study is important because low testosterone is a common complication of Type 2 diabetes and treating this problem could save the lives of countless men.

A testosterone test may provide men with Type 2 diabetes a glimpse of their risk of dying young. New research has connected untreated deficiencies of the hormone to a higher risk of death among this group.

The University of Sheffield researchers who conducted the study said that their findings are important because testosterone deficiencies are a known complication of diabetes. Many men with the condition suffer from hormonal problems. The findings indicate that more of these men should be receiving treatment.

For the study, the researchers examined the hormone levels of 587 men with Type 2 diabetes. The participants were classified as having healthy testosterone levels, receiving treatment for deficiencies or having untreated low levels. The men were then followed for six years.

During the course of the study, men who went untreated for testosterone deficiency were more than twice as likely to die, compared to those who had normal levels of the hormone. Participants who were on testosterone replacement therapy were the least likely to die.

The results showed that 20 percent of the participants with untreated testosterone deficiencies died during the study, while only 9 percent of those with normal levels died during the testing period. Just 8.6 percent of men who were being treated for hormone deficiencies passed away during the study.

The researchers said that their findings may help advance the understanding of complications that can arise in diabetics from hormone deficiencies.

Professor Hugh Jones, who led the investigation, said that the findings are important, but they are likely the tip of the iceberg when it comes to complications associated with low testosterone in men with Type 2 diabetes. There have been few investigations into how hormone deficiencies affect men with the condition.

"It is well known that men with Type 2 diabetes often have low testosterone levels, so it is important that we investigate the health implications of this," he said. "We now need to carry out a larger clinical trial to confirm these preliminary findings. If confirmed, then many deaths could be prevented every year."

The findings were presented at the annual meeting of the Society for Endocrinology, April 2011

Why Don't People Take Their Insulin as Prescribed?

Risk factors differed between Type 1 and Type 2 diabetic patients, with diet nonadherence more prominent in Type 1 diabetes and….

The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections, according to researcher Mark Peyrot, PhD.

Data were obtained through an internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat Type 1 or Type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission.

Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Risk factors differed between Type 1 and Type 2 diabetic patients, with diet nonadherence more prominent in Type 1 diabetes and age, education, income, pain, and embarrassment more prominent in Type 2 diabetes. It is not surprising that non-compliance in Type 1 diabetes patients was associated with poor eating habits. The researchers found that younger age, lower income, and embarrassment were the most important factors for poor compliance in people with Type 2 diabetes.

Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. The findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes. Although the results address the needed educational intervention, especially when it comes to embarrassment, pain, and interference with activities, it also points to the fact that healthcare teams need to talk with patients before this becomes a common practice, rather than a single occurrence.

Diabetes Care, Feb. 2011