The investigators analyzed data from the TriNetX Research Collaborative network, identifying 26,027 men with diabetes and hypogonadism who received testosterone therapy. Each treated patient was matched with an untreated counterpart using propensity score matching, creating a total study population of 52,054 men. The participants had a mean age of 58 years, and 71% were non-Hispanic White. The study tracked outcomes over an average follow-up period of 3.3 years.
The study led to the following findings:
- Testosterone therapy was associated with a 7% lower risk of acute kidney injury (HR 0.93) compared to untreated men.
- The risk of kidney failure requiring replacement therapy was reduced by 19% in men receiving testosterone (HR 0.81).
- Testosterone therapy was linked to a 15% lower risk of myocardial infarction (HR 0.85).
- The risk of ischemic stroke was reduced by 12% with testosterone therapy (HR 0.88).
- Testosterone therapy was associated with a 9% lower risk of atrial fibrillation (HR 0.91).
- Overall mortality was reduced by 15% in men receiving testosterone (HR 0.85).
These results suggest that testosterone therapy may offer broader health benefits for men with diabetes and hypogonadism beyond symptom management, potentially lowering the risk of serious kidney and cardiovascular events while improving survival. The researchers emphasize that these findings, observed under real-world conditions, support the consideration of testosterone therapy as a preventive intervention for kidney injury and cardiovascular complications in this population.
While the study provides compelling evidence, the authors note that further research is needed to clarify the biological mechanisms underlying these protective effects. Understanding how testosterone influences kidney and cardiovascular health could help optimize treatment strategies for men with diabetes and low testosterone.
"The study indicates that testosterone therapy in diabetic men with hypogonadism is linked to reduced risks of acute kidney injury, kidney failure requiring dialysis or transplantation, major cardiovascular events, and total mortality. These findings highlight the potential value of incorporating testosterone therapy into the management plan for eligible men with diabetes and hypogonadism, while future studies may further refine its role in clinical practice," the authors concluded.
Reference:
Bonnet, F., Vaduva, P., Halimi, JM. et al. Testosterone therapy is associated with reduced risk of acute kidney injury, kidney failure with renal replacement therapy, and cardiovascular events in men with diabetes and hypogonadism. Cardiovasc Diabetol 24, 378 (2025). https://doi.org/10.1186/s12933-025-02930-2
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