From the Guidelines
Testosterone gel 1.62% is not directly associated with causing hyperglycemia, according to the most recent and highest quality study available 1. The study, published in 2024, found no significant difference in the incidence of major adverse cardiac events, including nonfatal stroke, in men with confirmed hypogonadism who received daily transdermal 1.62% testosterone gel compared to those who received placebo gel 1. While the study did not specifically investigate the effect of testosterone gel on glucose metabolism, it did enroll men with preexisting cardiovascular disease or high risk of cardiovascular disease, including those with diabetes 1. However, another study published in 2021 discussed the management of diabetes and hyperglycemia in the hospital setting, including the use of glucocorticoids, which can cause hyperglycemia 1. Although this study is not directly related to testosterone gel, it highlights the importance of monitoring blood sugar levels in patients with risk factors for diabetes or prediabetes. Key points to consider when using testosterone gel 1.62% include:
- Monitoring blood sugar levels regularly, especially in individuals with a history of diabetes or elevated blood sugar
- Being aware of common signs of high blood sugar, such as increased thirst, frequent urination, fatigue, and blurred vision
- Contacting a healthcare provider promptly if symptoms of high blood sugar occur while using testosterone gel
- Potential adjustment of treatment plans or additional monitoring of glucose levels by a healthcare provider 1.
From the FDA Drug Label
During the 182-day, double-blind period of the clinical trial, 25 testosterone gel 1.62%-treated patients (10. 7%) discontinued treatment because of adverse reactions. These adverse reactions included ... 1 report of diabetes mellitus
- Hyperglycemia is not directly mentioned in the label, but diabetes mellitus is reported as an adverse reaction in one patient. The FDA drug label does not directly answer the question of whether testosterone gel 1.62% can cause hyperglycemia, but it does mention a related condition, diabetes mellitus, as an adverse reaction in one patient 2.
From the Research
Testosterone Gel and Hyperglycemia
- The effect of testosterone gel (testosterone) 1.62% on hyperglycemia is not directly stated in the provided studies, but the relationship between testosterone and glucose metabolism is explored in several studies 3, 4, 5, 6, 7.
- A study published in 2019 found that high circulating testosterone was associated with increased glycaemic variability in type 2 diabetes patients 3.
- Another study from 2023 found that testosterone replacement therapy improved body composition, insulin resistance, and glucose profile in patients with impaired fasting glucose and type 2 diabetes mellitus 4.
- A 2019 prospective cohort study found that low testosterone concentrations were associated with progression from normoglycemia to pre-diabetes, but not from pre-diabetes to diabetes 5.
- A 2022 cross-sectional analysis found that an increase in testosterone levels was related to a lower risk of conversion of prediabetes to manifest diabetes in prediabetic males 6.
- A 2024 substudy of the TRAVERSE randomized clinical trial found that testosterone replacement therapy did not improve glycemic control in men with hypogonadism and prediabetes or diabetes, and the incidence of progression from prediabetes to diabetes did not differ significantly between testosterone- and placebo-treated men 7.
Key Findings
- Testosterone may have a protective effect on glucose metabolism in males, but its role in females is less clear 4, 6.
- Testosterone replacement therapy may improve insulin resistance and glucose profile in patients with impaired fasting glucose and type 2 diabetes mellitus, but its effect on glycemic control is uncertain 4, 7.
- The relationship between testosterone and hyperglycemia is complex and may depend on various factors, including sex, age, and body mass index 3, 5, 6.