Effects of Hypogonadism and Testosterone Therapy on Diabetic Foot Complications

Daniel C. Jupiter, Kelli L. Faaitiiti, Robert A. Rodriguez, Efstathia Polychronopoulou, David Lopez

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Results of recent studies suggest that high levels of endogenous testosterone decrease the risk of diabetes. Testosterone therapy may delay the transition from prediabe-tes to diabetes and accelerate healing of diabetic foot ulcers in hypogonadal men. We inves-tigated whether testosterone therapy in this population decreases the occurrence of diabetic foot complications within 1 and 5 years of diabetes diagnosis. Methods: Optum’s deidentified Clinformatics Data Mart database was searched for male patients with diabetes. Associations between testosterone therapy and the occurrence of ulceration or the use of wound care were explored in the entire population and in those with and without hypogonadism using both bivariate and multivariate analyses. Results: Contrary to the hypotheses, testosterone therapy seems to confer increased risk of diabetic foot complications. In hypogonadal men with at least 1 year of follow-up after diabetes diagnosis, any use of testosterone therapy increased the odds of wound care utilization by a factor of 1.10 (95% confidence interval, 1.03–1.17), and the odds of ulceration by a factor of 1.13 (95% confidence interval, 1.03–1.24). Similar results are seen in all men, both with and without hypogonadism. Further exploration reveals that hypogonadism also increases the risk of wounds among people with diabetes with care utilization in the entire population. Conclusions: Further research is needed to elucidate the mechanisms by which hypogo-nadism and testosterone therapy impact diabetic foot complications, and whether these mechanisms are mediated by vascular or neurologic factors. (J Am Podiatr Med Assoc 114 (5), 2024; doi:10.7547/22-112).

Original languageEnglish (US)
JournalJournal of the American Podiatric Medical Association
Volume114
Issue number5
DOIs
StatePublished - Sep 1 2024

ASJC Scopus subject areas

  • General Medicine

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