[ag2sw]

This is an incredible article and well worth more study! Anyone else find it interesting?

Testosterone Tx Stymied by Depression
By Kristina Fiore, Staff Writer, MedPage Today
Published: September 01, 2012
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Action Points
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Note that this study found a high prevalence of hypogonadism in men with type 2 diabetes and also found that response to testosterone in this population was markedly reduced in patients with depression.
CHICAGO – Testosterone therapy may be useless in men with type 2 diabetes and hypogonadism who also have depression, researchers said here.

In a randomized controlled trial, diabetic men who weren't depressed had significant improvements in blood glucose and other metabolic parameters with hormone therapy, but those with depression gained no benefit, Geoffrey Hackett, MD, of Good Hope Hospital in Sutton Coldfield in England, and colleagues reported at the World Meeting on Sexual Medicine.

"All [parameters] improved in the nondepressed group, and there was a worsening of all symptoms in the group with depression," Hackett said.

Men with type 2 diabetes tend to have a high burden of co-occurring hypogonadism and depression, Hackett explained.

To assess whether treatment of low testosterone is affected by depression, the researchers conducted the randomized controlled BLAST Study -- an acronym for the included towns of Birmingham, Lichfield, Atherstone, Sutton Coldfield, and Tamworth – in 200 men from seven primary care practices who had type 2 diabetes and hypogonadism.

The study lasted 30 weeks, with about half the men continuing in a 52-week, open-label follow-up phase.

Participants were given either 1,000 mg testosterone undecanoate (Nebido) or matching placebo at baseline and at weeks 6 and 18.

The prevalence of hypogonadism was 50%. Almost a quarter of the population with type 2 diabetes (23%) was depressed, and these men tended to be younger and more obese, Hackett said.

For men who weren't depressed, testosterone therapy significantly reduced HbA1c levels (P=0.045).

It was also tied to significant reductions in weight (P=0.038), body mass index (P=0.02), and waist circumference (P=0.02), the researchers reported.

Yet they didn't see similar improvements in any of these parameters for patients who were depressed, Hackett said.

"We saw a highly significant treatment effect in the nondepressed group, and in the depressed group there was no response whatsoever," he said during the presentation.

"The take-home message," he continued, "is that it's important to screen for depression when initiating testosterone therapy, as both the metabolic and psychologic complications will be [affected]."

"You'll save yourself trouble if you detect those patients early," he said.

He added that clinicians should consider concomitant treatment of patients' depression when they go on hormone therapy, but that this trial would have been underpowered to study that endpoint.

Jacques Buvat, MD, of the Centre d'Etude et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique in Lille, France, who moderated the session during which the study was presented, said the findings were "very important" for the treatment of low testosterone in diabetic patients.

Hackett reported relationships with Bayer and Lilly.

Buvatt reported relationships with Lilly, Apricus Biosciences, Bayer-Schering, and Janssen.

Primary source: World Meeting on Sexual Medicine
Source reference:
Hackett G, et al "Depression significantly reduces the response to testosterone therapy in men with type 2 diabetes and hypogonadism" WMSM 2012; Abstract 166.

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Kristina Fiore
Staff Writer
Kristina Fiore joined MedPage Today after earning a degree in science, health, and environmental reporting from NYU. She’s had bylines in newspapers and trade and consumer magazines including Newsday, ABC News, New Jersey Monthly, and Earth Magazine. At MedPage Today, she reports with a focus on diabetes, nutrition, and addiction medicine.

[ag2sw]

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Originally Posted by ag2sw

Sorry, for the sake of freedom of SPEACH, may God reward your efforts; for the sake of this forum, I hope your fake hand bags and plastic shoes are filled with insulin, byetravand neuropathy, if you know what hat means!

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