SUN-LB114 Remission of Type 2 Diabetes (DMT2) in Hypogonadal Men Under Long-Term Testosterone Therapy

Objective: The increasing prevalence of DMT2 and obesity represents a growing clinical and health-care cost problem. These two pathologies simultaneously increase the risk of hypertension, myocardial infarction, stroke or venous thromboembolism. An existing but undetected testosterone deficiency will substantially hamper weight loss or render it impossible. In such cases, returning the testosterone level to normal range is therefore the necessary pre-condition to fight obesity and thus the related comorbidities. Materials and methods: 35 obese (waist circumference (WC) > 94 cm) men aged 48 [33;57] with diagnosed DMT2 (IDF 2019 criteria), hypogonadism (ISSAM 2015 criteria) and vitamin D deficiency (Endocrine Society Guidelines 2014 criteria) were treated with testosterone undecanoate (1000 mg 4 mL injected i.m. every three months following an initial 6-week interval), cholecalciferol 5. 000-10.000 IU per day. 29 patients received 1000-2000 mg per day, 1 patient received liraglutide 1,8 mg a day + metformin 1500 mg a day, 1 patient received Sitagliptin 100 mg and metformin 1000 mg a day. 4 patients did not use anti-diabetic treatment ever. The duration of follow up was 36 months. Waist circumference (WC, cm), glucose (mmol/L), HbA1c (%), total testosterone (nmol/L) and vitamin D (25(OH)D3, ng/mL) were assessed at baseline and after 36 months of follow up. Statistical research was made using a software package statistics (StatSoft Inc. U.S., version 6.0). Quantitative data are presented as medians and quartile range. When comparing the quantitative data of two groups Wilcoxon test was used. Values were considered statistically significant if p <0.05. Results: All patients had no DMT2 diagnostic criteria after 24 months of treatment. WC changed from 107 [102;116] to 94 [88.5;97.5], HbA1c from 7,2 [6.9;7,7] to 5,7 [5.25;5.8], TT from 7.37 [6.2;9.18] to 24.65 [22.3;25.9], 25(OH)D3 from 20.2 [11.7;26.2] to 72 [65;88] at baseline and after 24 months of follow up, respectively. All changes were statistically significant. Anti-diabetic therapy was cancelled in all patients after 20,5 [15;24] months of follow up. All patients remained under further follow up for the period up to 36 months, no cases of DMT2 recurrence were registered.Conclusion: We conclude that correction of testosterone and vitamin D deficiency may work as a necessary stimulus for consequential facilitation of weight reduction and associated recovery, particularly in terms of a complete remission of diabetes. Long term data is needed.