Patient Instruction

Treating Diabetes With Testosterone

Edward Lichten, M.D.,PC
555 South Old Woodward Suite #700
Birmingham, MI 48009 





1.   Hemoglobin A1c

The hemoglobin A1c greater than 6.0 defines diabetes. It is the measure of the percentage of the red blood cell that contains glucose.   

2.   3 hour Glucose tolerance test with hourly insulin GTT-I

      The purpose of the 3-hour glucose test with insulin is to differentiate those individuals who may require insulin rather than continue oral agents.  The summation of the insulin values at 0,1, 2, and 3 hours should be greater than 80. If not, or if the one-hour insulin is not greater than four times the fasting, the individual is classified as insulin requiring.  The explanation is the insulin requiring individuals fail to release enough insulin at the right time to control their blood glucose.


Use of Testosterone

There are three forms of testosterone that are usable for the adult onset diabetic male.  These three forms of testosterone are all injectable because testosterone on the skin is aromatized, converted, to estrogen. 

(1).  Testosterone cyprionate at concentrations of 100-150 mg intramuscularly per week is the beginning dose. Testosterone cyprionate is the least expensive and is available at most regular pharmacies and is covered by insurance.

(2).  Testopel® is an FDA approved Class-III 75mg testosterone pellet that is for once-per month implantation by the physician in the upper outer buttock (not anus). The number of pellets vary from 5 to 10 depending on the weight and severity of the diabetic state. Costs vary from $250 to $400 and may be a covered benefit from insurance.

(3).  Nandrolone is an injectable testosterone used in concentrations of 100-150 mg per week. It is unique in that only 20% of it aromatizes to estrogen. This is preferred for those individuals who are unable to normalize their elevated Estradiol and Sex Hormone Binding Globulin both Testosterone Cyprionate or Testopel®.



Use of Testosterone in Lowering Medication in the Diabetic Male

For most men, the addition of testosterone cyprionate, Testopel® or nandrolone will increase the energy in the cell making any natural insulin available more effective. Expect a drop in insulin requirement by 25-45% in the first week, Check with your doctor but reducing each injection of insulin and any long-acting insulin accordingly. The benefit of testosterone therapy is that there is a significantly reduced risk of hypo-glycemia, low blood sugar. Consider the testosterone therapy somewhat protective as you strive to lower your fasting glucose and hemoglobin A1c. 

For men on oral agents, the Glucose Tolerance Test with Insulin can define which individuals should discard sulfonylurea, Actos, and newer products. Any individual with a Summation of Insulin less than 80 has no need for oral agents except Metformin. This is because your body releases inadequate insulin when needed.


Follow-up, Risks and Complications

Testosterone and nandrolone are FDA approved products that has been used in the United States for more than 45 years. The risks of any injections or implantation is bleeding, infection, allergic reaction and for the pellet, extrusion. Treatment is local heat, a simple antibiotic for three days, and change of the base the testosterone is mixed in.


All forms of testosterone are approved to treat anemia. As such, testosterone raises the hemoglobin. For diabetic men, it is rare that the testosterone therapy will cause a dramatic increase in red blood count. The measurements are hematocrit and hemoglobin. If the hemoglobin goes above 17.6 mg/ml, it is recommended to donate blood at the Red Cross.  This can be done safely every 3 months.

If there are unanswered questions, please contact:

Edward M. Lichten, M.D., F.A.C.S.

180 East Brown Street

Birmingham, Michigan 48009

telephone: 248.593.9999