[NO] Effects Of Testosterone Treatment on Glucose Metabolism and Symptoms in Men with Type 2 Diabetes and The Metabolic Syndrome Context The effects of testosterone treatment on glucose metabolism and other outcomes in men with type 2 diabetes (T2D) and/or the metabolic syndrome are controversial. Objective - To perform a systematic review and meta-analysis of placebo-controlled double-blind randomized controlled clinical trials (RCT) of testosterone treatment in men with T2D and/or the metabolic syndrome. Data Sources - A systematic search of RCTs was conducted using Medline, Embase and the Cochrane Register of controlled trials from inception to July 2014 followed by a manual review of the literature. Study selection Eligible studies were published placebo-controlled double-blind RCTs published in English. Data Extraction - Two reviewers independently selected studies, determined study quality and extracted outcome and descriptive data. Data Synthesis - Of the 112 identified studies, seven RCTs including 833 men were eligible for the meta-analysis. In studies using a simple linear equation to calculate the homeostatic model assessment of insulin resistance (HOMA1), testosterone treatment modestly improved insulin resistance, compared to placebo, pooled mean difference (MD) −1•58 [−2•25, −0•91], P < 0•001. The treatment effect was nonsignificant for RCTs using a more stringent computer-based equation (HOMA2), MD −0•19 [−0•86, 0•49], P = 0•58). Testosterone treatment did not improve glycaemic (HbA1c) control, MD −0•15 [−0•39, 0•10], P = 0•25, or constitutional symptoms, Aging Male Symptom score, MD −2•49 [−5•81, 0•83], P = 0•14). Conclusions - This meta-analysis does not support the routine use of testosterone treatment in men with T2D and/or the metabolic syndrome without classical hypogonadism. Additional studies are needed to determine whether hormonal interventions are warranted in selected men with T2D and/or the metabolic syndrome. Grossmann M, Hoermann R, Wittert G, Yeap BB. Effects of testosterone treatment on glucose metabolism and symptoms in men with type 2 diabetes and the metabolic syndrome: a systematic review and meta-analysis of randomized controlled clinical trials. Clinical Endocrinology. onlinelibrary.wiley/doi/10.1111/cen.12664/abstract
Posted on: Tue, 30 Dec 2014 15:25:31 +0000
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