Glycemic benefits with adherence to testosterone therapy in men with hypogonadism and type 2 diabetes mellitus

Background While previous studies have demonstrated testosterone's beneficial effects on glycemic control in men with hypogonadism and Type 2 Diabetes, the extent to which these improvements are observed based on the degree of treatment adherence has been unclear. Objectives To evaluate the effects of long‐term testosterone therapy in A1C levels in men with Type 2 Diabetes Mellitus and hypogonadism, controlling for BMI, pre‐treatment A1C, and age among different testosterone therapy adherence groups. Materials and methods We performed a retrospective analysis of 1737 men with diabetes and hypogonadism on testosterone therapy for 5 years of data from 2008–2018, isolating A1C, lipid panels, and BMI results for analysis. Subjects were categorized into adherence groups based on quartiles of the proportion of days covered (> 75% of days, 51–75% of days, 26–50% of days and 0–25% of days), with >75% of days covered considered adherent to therapy. Results Pre‐treatment median A1C was 6.8%. Post‐treatment median A1C was 7.1%. The adherent group, >75%, was the only group notable for a decrease in A1C, with a median decrease of −0.2 (p = 0.0022). BMI improvement was associated with improved post‐treatment A1C (p = 0.007). When controlling for BMI, age, and pre‐treatment A1C, the >75% adherence group was associated with improved post‐treatment A1C (p