TY - JOUR
T1 - Effects of Hypogonadism and Testosterone Therapy on Diabetic Foot Complications
AU - Jupiter, Daniel C.
AU - Faaitiiti, Kelli L.
AU - Rodriguez, Robert A.
AU - Polychronopoulou, Efstathia
AU - Lopez, David
N1 - Publisher Copyright:
© 2024, American Podiatric Medical Association. All rights reserved.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - 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).
AB - 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).
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U2 - 10.7547/22-112
DO - 10.7547/22-112
M3 - Article
C2 - 39546360
AN - SCOPUS:85209703315
SN - 8750-7315
VL - 114
JO - Journal of the American Podiatric Medical Association
JF - Journal of the American Podiatric Medical Association
IS - 5
ER -