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Diabetic men have another option

Knight Ridder/Tribune Business News


June 16--Male patients suffering from diabetes can now look forward to an alternative treatment that could help them control their condition better ? through testosterone replacement therapy.

However, this treatment is only prescribed to those who were diagnosed with low testosterone, through a blood test.

According to Dr Manaf El Hashimi, urologist at Lifeline Hospital, patients with diabetes are more likely to have low testosterone and vice-versa.

A study by the International Diabetes Federation (IDF) in 2009 showed that "one-third of men with Type 2 diabetes have low testosterone".

"Testosterone decreases with age, and this will cause some changes that will increase obesity and insulin resistance, meaning pre-diabetes stage. Obesity by itself will cause some changes that will decrease the testosterone level. So, low testosterone results in obesity and diabetes, and, by itself, obesity and diabetes can decrease testosterone," explained Dr El Hashimi.

According to him, those with low testosterone have more than double risk of having obesity and diabetes and less than double of having hypertension and hyperlipidemia.

"If you have diabetes, obesity and hypertension, we have to check for your testosterone, this is the point that missed by all doctors. If it is low and you treat them, then you control your disease and you prevent further complications," said the specialist.

A study published in the Journal of Andrology in 2009 showed that diabetics going through exercise and diet have only 40 per cent successful rate of managing their condition. But when testosterone replacement therapy was added to their regimen, the control spiked to 87.5 per cent.

Citing another study in 2011, Dr El Hashimi pointed out that when diabetes patients get testosterone treatment, their mortality rate goes up to 20 per cent as opposed to just nine per cent.

Despite these findings, doctors here are not aware of this therapy or recommend a testosterone test for their patients. They are not also aware of the availability of the preparation here.

There are different testosterone formulations available in the country, which are tightly controlled. These include intramuscular injection, gel or patches and oral capsules. However, testosterone therapy is not advisable for those with prostate cancer.

Lifeline Hospital has started giving patients, who fit the profile, a questionnaire asking about their physical, psychological and sexual health to detect if they are a candidate for the testosterone test. "This is not very specific but very sensitive; it will detect. You cannot diagnose 100 per cent (clinically), that's why we need to do blood test," Dr El Hashimi said.

According to the IDF 2010 Atlas, the UAE ranks second in the top ten countries with the prevalence of diabetes.

"We have the highest rate of obesity and diabetes. By logic, we have, maybe, the highest prevalence of low testosterone, but we don't have statistics," Dr El Hashimi pointed out.

The Health Authority-Abu Dhabi's (HAAD) 2010 statistics revealed that only 20 per cent of the diabetics in the emirate have their condition well under control. Obesity, diabetes and cardiovascular diseases accounted for over a quarter of deaths in 2009 in Abu Dhabi.

Testosterone, the principal sex hormone in men, is important not only for normal sexual function but also for maintaining bone and muscle strength, mental and physical energy, and overall well-being. Low testosterone is associated with diminished libido, erectile dysfunction, increased fat mass, decreased muscle, bone mass and energy, depression and anaemia.

Age plays a major factor. Testosterone decreases sharply at 40 years, then gradually thereafter. The World Health Organisation (WHO) study has shown that this affects 20 per cent of males at the age of 60.

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(c)2012 the Khaleej Times (Dubai, United Arab Emirates)

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