Improvement of the diabetic foot upon testosterone administration to hypogonadal men with peripheral arterial disease. Report of three cases

BACKGROUND: Lower extremity complications (neuropathy, ulceration, infection, and peripheral arterial disease) are common in diabetes mellitus. There is an inverse relation between plasma testosterone and insulin sensitivity, type 2 diabetes mellitus and HbA1c concentrations. METHODS: We report the beneficial effects of administration of testosterone to three men with a diabetic foot whose serum testosterone was subnormal. RESULTS: Upon normalization of serum testosterone there was an improvement of hyperglycemia, a decrease of leukocytes and of fibrinogen levels, an increase of antithrombin III activity and of tissue oxygen pressure. The wound showed granulation. CONCLUSION: Beneficial effects of administration of testosterone to hypogonadal with a diabetic foot may be due to improved vascularization and to anti-inflammatory action.