Diabetes & Male Menopause

Nationwide, an estimated 15 million men age 45 and older suffer from Low T.  Just what is Low T?  Low T is Low Testosterone.  After age 30, the average annual decline in serum testosterone in men is approximately 1% to 2%.  Men with diabetes are more than twice as likely to have low testosterone (Low T) compared to other men.  Plus, overweight men are also more than twice as likely as other men to have Low T.  It is estimated that fewer than ten percent of men with the condition are currently receiving treatment.  Unlike “women’s menopause,” this condition is not a natural course of a man’s life cycle.

Low T can also be affected by other medical conditions, not just diabetes.  High blood pressure, asthma, and COPD can also affect testosterone levels and increase one’s risk for Low T.  Symptoms of Low T can include a low sex drive, erectile dysfunction, depression and fatigue.  In addition, however, low levels of this male hormone can also contribute to higher body fat, reduced muscle mass, and decreased bone mineral density, therefore this condition is not just isolated to libido, but instead impacts many aspects of one’s health.  Low T can be easily diagnosed with a simple blood test, and treatment involves testosterone supplementation.

However, the risk of enlarged prostate exists with testosterone supplementation, and therefore treatment must be carefully monitored to prevent negative effects to the prostate.  Men with prostate cancer cannot be given testosterone supplementation.  Low T is defined as a total testosterone (TT) level of ≤300 ng/dL.  Because the secretion of testosterone is diurnal, it should be measured in the morning, usually between 8:00 AM and 11:00 AM, rather than other times of the day.  Before initiating testosterone replacement therapy, a second confirmatory test should be performed.

It is suggested by most clinical professional organizations (e.g. The Endocrine Society), that hypogonadism, a clinical syndrome caused by the failure of the testes to produce physiological levels of testosterone and adequate spermatozoa, include low T as part of the diagnosis.  However, guidelines are inconsistent with the level of TT that defines hypogonadism.  The American Association of Clinical Endocrinologists defines hypogonadism as a testosterone level of < 200 ng/dL.

The prevalence rate of Low T among men with diabetes (and overweight men), is just one more reason why the management of diabetes (and weight management) is so crucial.  Managing blood glucose levels can, at first, seem like a daunting task but its benefits will be reaped in so many different aspects of one’s health.

If you have diabetes, it is crucial that you learn how to manage it with proper nutrition, meal management, physical activity, daily blood glucose monitoring with a glucometer, as well as the appropriate diabetes medications.  If you are overweight and have never been tested for diabetes, be sure to see your healthcare provider to be screened for this disease.

By Cheryl Winter, MS RD, MS APRN, CDE, BC-ADM, FNP-BC

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