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Diabetic men at risk of low testosterone

Men over the age of 45 with diabetes are more than twice as likely as non-diabetic men in the age group to have low testosterone, making them susceptible to sexual dysfunction, according to a study presented on Saturday.

"Too many times people with diabetes have gotten the short end of the deal," said study investigator Dr. Sherwyn Schwartz, director of the Diabetes & Glandular Disease Clinic in San Antonio, Texas. "This is a common problem that we need to start looking for."

The study, which screened 2,162 men, with an average age of over 60, found that half of the 474 men with diabetes also had low testosterone, or hypogonadism.

That means men age 45 and older with diabetes have 2.09 times higher odds of having hypogonadism compared to non-diabetic men, the researchers said.

"This is an astonishing prevalence rate. The implication is that management of diabetes hinges on more than just managing glucose levels," said Dr. Natan Bar-Chama, a urologist with Mount Sinai Hospital in New York.

The research was sponsored by Solvay Pharmaceuticals Inc., which sells a testosterone gel called AndroGel.

Low levels of the male hormone are associated with diminished sex drive, erectile dysfunction, higher body fat, reduced muscle mass and decreased bone mineral density as well as depression and fatigue.

"This is not the natural course of life in a man who is 45 or 50 years old. It’s not like women’s menopause," said Schwartz, referring to studies showing that female hormone replacement therapy does not protect against disease and increases the chance of having a stroke.

About 56 percent of men in the study with diabetes and low testosterone reported a decreased ability to perform sexually.

Testosterone levels are checked with a blood test and treatment involves testosterone supplements, which raise the risk of enlarged prostate and cannot be used by men with prostate cancer.

"This is not isolated to libido. The hormone has an impact on numerous medical conditions," Bar-Chama said.

Men who are treated with testosterone supplements must be carefully monitored so that levels fall within normal ranges and the prostate is not affected, he said.

"Long-term data is lacking. The prudent approach is to supplement to physiological levels in order to achieve adequate fat distribution, quality of life and sexual function while being vigilant," Bar-Chama said.