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Experts say testosterone levels decline with age in men. Peter Finch/Getty Images
  • Researchers are reporting that higher levels of testosterone may help lower the type 2 diabetes risk for men under the age of 65 who are overweight or have obesity.
  • The researchers added that there were no detectable benefits of testosterone on type 2 diabetes risk for men over the age of 65.
  • Experts note there are still ways for men to manage diabetes risk after age 65.

A new study says higher levels of testosterone can lower the risk of type 2 diabetes for men 65 years or younger who are overweight or have obesity.

However, this doesn’t seem to apply to men over the age of 65.

The study, which hasn’t been published yet in a peer-reviewed journal, was presented today at ENDO 2024, the Endocrine Society’s annual meeting in Boston.

Mahesh Umapathysivam, a lead researcher from the University of Adelaide in Australia, said in a statement that the research team wanted to better understand the relationship between testosterone and type 2 diabetes risk across a range of testosterone levels.

He said they also wanted to examine interactions between testosterone and different diabetes risk factors in midlife and in older men.

“A low blood testosterone concentration is an independent risk factor for developing type 2 diabetes, and high levels of testosterone appear protective against the development of type 2 diabetes,” Umapathysivam said.

The team examined data from the MAILES Cohort, a group of men ages 35 to 85 years living in urban Adelaide.

This particular study looked at 1,315 men, none of whom had testosterone treatment, diabetes, or cancer at the beginning of the study.

After five years, 110 of the subjects had developed type 2 diabetes.

The scientists said they corrected for factors known to affect the risk of developing type 2 diabetes. Those factors included smoking, alcohol use, age, waist circumference, family history of diabetes, measures of blood sugar, medication use, and self-reported physical activity.

The researchers reported that blood testosterone concentration was associated with the risk for developing type 2 diabetes.

Specifically, they said the higher a man’s blood testosterone level, the lower their risk of developing type 2 diabetes before the age of 65.

“This implies that higher testosterone blood concentrations are associated with reduced risk of developing type 2 diabetes,” Umapathysivam said. “In contrast, there were no detectable effects of blood testosterone levels on diabetes risk in men over age 65.”

“Maintaining a healthy weight, exercising regularly and avoiding alcohol helps maintain a normal testosterone level in most men and also helps prevent type 2 diabetes,” Umapathysivam added.

Steve Gendron, PhD, a specialist in immunology and endocrinology as well as the founder of health website Mindful Living Choice, told Medical News Today that a men’s testosterone naturally drops as they age and sometimes men don’t have enough of the hormone left by age 65 to keep type 2 diabetes at bay.

“That battery might not have enough juice left to fend off diabetes effectively,” said Gendron, who was not involved in research. “Older men often juggle more health problems. It’s like our hero testosterone is now up against a whole gang of villains — heart disease, reduced muscle mass, frailty — you name it. This makes it tougher for testosterone to fight off diabetes single handedly.”

“The body’s ability to respond to testosterone might weaken with age. Imagine trying to tune into your favorite radio station but the signal keeps getting fuzzier. Even if there’s enough testosterone, the body might not be picking up the signal as well,” he noted.

Gendron said it’s important for men to talk to their healthcare provider before deciding whether to take testosterone supplements.

“While testosterone might help younger men fend off type 2 diabetes, it’s just one part of the equation,” he said.

Dr. Jamin Brahmbhatt, an urologist at Orlando Health in Florida who was not involved in the research, told Medical News Today that not only is a decline in testosterone after age 65 due to natural decline, it’s also because of an increased presence of comorbidities and age-related metabolic changes affecting insulin sensitivity.

“Men currently should not take testosterone supplements unless they have been clinically diagnosed with low testosterone levels and are experiencing symptoms of deficiency,” Brahmbhatt said. “It’s essential to consult with a healthcare provider that follows guideline-based care to determine the appropriate course of action based for each unique patient.”

Brahmbhatt said he thinks as time goes on, we’ll see more studies similar to this “pushing us to rethink our guidelines and consider more broader indications for replacement therapy.”

“Testosterone plays a vital role in metabolic processes, including glucose and fat metabolism,” Brahmbhatt explained. “Higher levels of testosterone can improve insulin sensitivity and reduce fat mass, both of which are crucial factors in preventing type 2 diabetes. This aligns with the study’s finding that higher testosterone levels are protective against the development of diabetes in men under 65.”

Brahmbhatt said other holistic approaches could help offset the increased risk of type 2 diabetes as testosterone declines after age 65.

“Maintaining a healthy weight, regular physical activity, and avoiding excessive alcohol intake are critical components of preventing type 2 diabetes,” Brahmbhatt said. “These lifestyle factors also help maintain normal testosterone levels, creating a beneficial cycle. Men should focus on these foundational health practices as the primary method for diabetes prevention.”

“Maintaining a healthy lifestyle is still your best bet,” added Gendron. “This means staying active, eating a balanced diet, getting regular check-ups, and keeping stress in check. Think of it as assembling an all-star team to keep you in top shape.”