Testosterone Plus Lifestyle Changes May Lower Type 2 Diabetes Risk in Older Men: Study - Video

Healthy habits remain the foundation of diabetes prevention, but new research suggests hormone treatment may provide an extra metabolic boost for some older men.

Testosterone therapy, when combined with a structured lifestyle program, may improve body composition, blood sugar control, and sexual desire in older men at high risk of type 2 diabetes, according to new research presented at ENDO 2026, the Endocrine Society's annual meeting.

The findings come from a follow-up analysis of the Testosterone for the Prevention of Type 2 Diabetes Mellitus (T4DM) trial, which originally enrolled 1,007 men aged 50 to 74 with central obesity and either prediabetes or newly diagnosed type 2 diabetes. The original study had already shown that testosterone therapy alongside lifestyle changes lowered the likelihood of developing diabetes after two years.

The new analysis tracked 121 participants who continued blinded treatment for an additional two years after completing the formal lifestyle program. Researchers found that the greatest improvements in blood sugar control occurred during the first two years when participants actively engaged in diet and exercise support. Although the glucose-lowering effect weakened by the fourth year, blood sugar levels remained significantly better than those in the placebo group.

Importantly, reductions in body fat, increases in muscle mass, and improvements in sexual desire achieved during the first two years were maintained throughout the four-year follow-up. However, testosterone treatment did not significantly improve overall quality of life compared with placebo, and no new safety concerns emerged during the extended study.

The researchers say the findings encourage clinicians to assess metabolic health, abdominal obesity, muscle strength, sexual symptoms, and testosterone levels together rather than treating each issue separately. They also reinforce that lasting benefits depend on sustained lifestyle changes, with hormone therapy serving only as a supportive strategy for carefully selected patients.

REFERENCE: Testosterone alone is not a replacement for lifestyle changes in older men at risk of T2D; https://www.endocrine.org/news-and-advocacy/news-room/2026/wittert-press-release-endo-2026