Kerry D Friesen, M.D.

Men, Low Testosterone And The Risk For Diabetes

Posted on 16. Nov, 2009 by Kerry D Friesen, M.D. in Brain Health, Men's Health

More Muscle Means Less Diabetes!

Some Fast Facts:

Men with diabetes have lower testosterone levels than healthy men

Testosterone replacement therapy is readily available and seldom utilized

Testosterone is critical for mental, physical and sexual health in both men and women

Low testosterone is linked to diabetes, obesity, heart disease, erectile dysfunction, depression and high blood pressure

Simple cost effective screening tests are available to help diagnose low testosterone (eg. the *ADAM questionnaire—Androgen Deficiency in Aging Male)

For Men Only (Ok ladies can peek)

1. Do you have a decrease in libido (sex drive)?
2. Do you have a lack of energy?
3. Do you have a decrease in strength and/or endurance?
4. Have you lost height?
5. Have you noticed a decreased “enjoyment of life”?
6. Are you sad and/or grumpy?
7. Are your erections less strong?
8. Have you noted a recent deterioration in your ability to play sports?
9. Are you falling asleep after dinner?
10. Has there been a recent deterioration in your work performance?

If you answered “Yes” to any 3 questions OR “YES” to question 1 or 7,  consider talking to your doctor about a blood test to measure serum tesosterone levels.  Better yet, take this questionnaire to your doctor and get the answers you’re looking for.

The Health In Men Study: Low “Normal” Testosterone = Insulin Resistance And Diabetes

According to a recent study published in the †European Journal of Endocrinology, even low “normal” levels of testosterone are associated with an increase in insulin levels and Type 2 diabetes.

Elevated insulin levels promote weight gain specifically around the waist.

So-called “truncal” obesity signals insulin levels to rise even higher making our cells increasingly resistant to the all important glucose lowering function of insulin.  In addition, chronically  elevated insulin levels suppress the body’s natural production of testosterone and so on and on the cycle goes!

In the study noted above, as insulin levels rose, serum testosterone levels were driven lower with the lowest levels of testosterone observed in men with the most severe insulin resistance.

How Do I Know If I Have Insulin Resistance Syndrome?

Insulin resistance occurs when our cells no longer recognize insulin’s ability to transport glucose (blood sugar) out of the blood stream to inside the cell where metabolism and energy production takes place.

Here are some indicators that insulin resistance is present:

1. Abdominal obesity: a waist circumference over 102 cm (40 in) in men and over 88 cm (35 inches) in women.
2. Serum triglycerides 150 mg/dl or above.
3. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women.
4. Blood pressure of 130/85 or more.
5. Fasting blood suger of 110 mg/dl or above. (risk for heart diseases begins when blood sugar is >90 mg/dl)

What To Do?

If you think you might be insulin resistant, ask your doctor to order the following tests in addition to the check list mentioned above:

Serum testosterone, free and total testosterone, SHBG, PSA, LH (luteinizing hormone), DHEA-S and for some men and women, fractionated estrogen levels.

Consider starting a simple exercise program with the primary goal of toning and building lean muscle.  Forget crunches for now.  Truncal obesity means the excess weight is packed deep around internal organs and cannot be eliminated by liposuction or abdominal exercises.

Adopt the Mediterranean diet with a special emphasis on low glycemic index foods.  Consider adding a supplement to enhance glucose transport and decrease circulating insulin levels.

Finally remember, “more muscle means less diabetes!”

*ADAM questionnaire the brainchild of : Morley JE et al. Validation of a screening questionnaire for
androgen deficiency in aging males. Metabolism. 2000;49:1239-1242.

† European Journal Of Endocrinology, 2009 Oct;161(4):591-8. Epub 2009 Aug 6.

Tags: ADAM, DHEA-S, diabetes, free and total testosterone, heart disease, insulin resistance, LH, PSA, sexual health, testosterone, truncal obesity