P344Clinical effectiveness of testosterone replacement therapy in hypogonadal men with Type 2 diabetes: A systematic review and meta‐analysisM ABDALLA1, J James2 and A Dunkley21Health Science, University of Leicester, Leicester, UK, 2Leicester Diabetes Centre, Leicester General Hospital, Leicester, UKAims: We aimed to conduct a systematic review and meta‐analysis of randomised controlled trials (RCTs) to determine the clinical effectiveness of testosterone replacement therapy (TRT) in hypogonadal men with Type 2 diabetes.Methods: A systematic search of six online databases was performed to identify studies reporting RCTs utilising testosterone interventions for hypogonadal men with Type 2 diabetes. A total of 313 articles were identified and reviewed independently and assessed for risk of bias using Cochrane risk of bias tool. Eight eligible studies met the inclusion criteria were included in the met‐analysis.Results: TRT significantly reduced HbA1c% (MD = −0.94; 95% confidence interval (CI) −1.53, −0.35, p = 0.002), fasting plasma glucose levels (MD = −1.91; 95% CI (−3.21, −0.61, p = 0.004) and fasting serum insulin (MD = −2.70; 95% CI (−3.60, −1.79, p = 0.01)). There were no significant effects on body mass index (BMI) (MD = −11; 95% CI (−0.48, 0.26, p = 0.57)), homeostatic model assessment index of insulin resistance (HOMA‐IR) (MD = −0.97; 95% CI (−2.45, 0.52, p = 0.20)), parameters of lipid profiles (MD = −0.07; 95% CI (−0.58, 0.43, p = 0.78)) and blood pressure (MD = 0.18; 95% CI (−0.38, 0.73, p = 0.53)).Conclusion: Our findings suggest TRT significantly improved parameters of glycaemic control and decreased levels of fasting serum insulin in hypogonadal men with Type 2 diabetes with no other significant clinical effects. Many previous studies have claimed that TRT have significant effects on BMI, lipid profiles and HOMA‐IR, but our study demonstrates the opposite. Therefore, the results of this study might help change the clinical practice.
Diabetic Medicine – Wiley
Published: Jan 1, 2018
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