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In 1922, Banting and Best discovered insulin and
changed the world of medicine. Not only did they
discover a natural therapy to prevent death from
diabetes, they gave away their patent to humanity.
Today, 85 years later, we have proven that injectable
testosterone is, in fact, more important than insulin
because it is applicable to 5 times more diabetic men
and another yet undiagnosed 10 fold.

In 1996, I discovered that my fasting insulin dropped
from 10 miu/ml (borderline) to <2 while on injectable
testosterone therapy. An adult diabetic male, J.N., 48
years old with confirmed abnormal glucose tolerance
was able to lose 85 pounds in 10 months and regain
his youthful physical, exercise and sexual vigor while
on testosterone replacement. When retested at two
years, his glucose tolerance was entirely normal.

This information and more gleaned from another 12
diabetic men and women convinced James Sowers,
M.D., professor and chairman of metabolism and
endocrinology to support a pilot study at Providence
Hospital in Detroit in 1997. Project 607-97 showed

1. All diabetic men were hypogonadal based on
measurement of total testosterone or bio-available T.

2. All men showed improvment in glycemic control
on injectable testosterone therapy

3. All men reported improvement in sexual function
or less depression and improved sleep on injectables.

4. Two-thirds of the adult onset diabetic men, many
who were diabetic for more than 4 years, showed a
flat insulin response to the oral glucose given at the
glucose tolerance test. These individuals uniformly
stopped their prescription hypoglycemic medications
without worsening their diabetic condition.

5. Parenteral testotosterone lowered the need for
insulin in the insulin dependent diabetics and improved
the glycemic control in adult men after they had
discontinued sulfonylurea medications.

1. JAMA CONFIRMS ALL DIABETIC MEN are HYPOGONADAL

JAMA 2006;295:1288-1299. EL Ding. Harvard. Boston USA. Cross-
sectional studies indicated that testosterone level was significantly lower in
men with type 2 diabetes ....Similarly, prospective studies showed that men
with higher testosterone levels (range, 449.6-605.2 ng/dL) had a 42% lower
risk of type 2 diabetes

2. EUROPEANS TREATS DIABETIC MEN WITH TESTOSTERONE

Kapoor D. Eur J Endocrinol 2006; 254(6): 899-906. Testosterone
replacement therapy improves insulin resistance, glycaemic control, visceral
adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes.

In Letters to the Editor in JAMA Jul 12, 2006, Phillips restates
DING's findings in another way, showing that the increase in
estradiol and the decrease in testosterone are more significant in
predicting insulin resistance/diabetes than testosterone alone.
And the changes in sex hormone binding globulin (SHBG)
accelerates the role of estradiol in worsening the metabolic
state.

The role of testosterone in diabetic men is to improve the
transport of sugar (glucose) from the blood stream into the cell.
If insulin is one of the two keys to the safety-box (cell), then
testosterone bound to SHBG is the other. Simply spoken,
testosterone reduces the need for more and more insulin. And
when the individual needs to raise sugar (glucose) from stored
fat, testsoterone increases its conversion and availability during
that life-saving crisis.

Therefore, there should be no fear about beginning testosterone
injection replacement in diabetic men without the risk factors of
eleveated PSA, prostate or testicular cancer. Gels do not work
as the skin aromatizes testosterone to estradiol worsening in
time the estradiol/testosterone ratio and the progress to insulin
resistance. Routine replacement is 100mg IM weekly; Kapoor
used 200mg IM every two weeks. We routinely use 150 mg
weekly for men over 200 pounds and follow the testosterone,
SHBG and estradiol every 6 weeks. Testosterone may raise
hemoglobin so a donation of one unit ot the Red Cross may be
suggetsed every 3-4 months. Otherwise, few side-effects
except increased libido, increased muscle mass, lost weight and
drops in total cholesterol are usually reported.