Sven Wombwell
Article by: Sven Wombwell
Estimated 9 minutes read

Low testosterone and diabetes, in particular type 2, are closely connected. Being overweight and carrying too much visceral fat are the most common causes of type 2 diabetes in men. Visceral fat typically develops from middle age onwards and is often caused by the natural decline in testosterone levels, an unhealthy diet, and a lack of exercise. TRT can combat the undesirable symptoms of low testosterone levels, particularly those associated with type 2 diabetes.

What is Type 2 diabetes?

  • Type 2 diabetes is a common condition where blood sugar levels (glucose) become too high.
    Common symptoms include excessive thirst, needing to urinate frequently, and tiredness. It can also increase your risk of issues with the eyes, heart, and nerves, disrupting blood flow around the body and often causing erectile dysfunction.
  • Usually, a lifelong condition, type 2 diabetes, requires diet changes, daily medication, and regular check-ups.
  • Type 2 diabetes develops due to problems with a hormone called insulin. When you eat, your pancreas releases insulin, processing sugars in your blood and converting them into energy. This process stops when this conversion is disrupted by insulin resistance - causing blood sugar levels to spike.
  • Being overweight or obese increases the chances of developing type 2 diabetes. In this disease, the body makes enough insulin, but your cells have become resistant to it. Your body, therefore, can't use or store glucose for energy. Instead, the glucose stays in your blood.

How is Testosterone Linked with Type 2 Diabetes?

Testosterone is a steroid hormone that is often called the "male sex hormone," which gives men many of their male traits. There is a significant link between low testosterone and diabetes (Type 2) in men, with many studies 1 proving the association. In fact, up to a third of all people (including young people3) with type 2 diabetes have hypogonadism, a condition where the testicles produce insufficient testosterone.

The link between lifestyle, low testosterone, and diabetes 2 is pretty straightforward, and both may contribute to impaired performance, mood, and libido. Countless other studies show that men with diabetes are likely to have low testosterone and vice-versa, but why is this?

Fat, The Main Cause of Type 2 Diabetes

Fat is one of the most common causes of low testosterone and diabetes (type 2). Testosterone, thyroid hormones, insulin, and cortisol significantly influence many bodily functions, from your appetite to your sex drive and your metabolism's efficiency. In particular, they alter how fat is distributed around your body. Fat is stored subcutaneously under the skin or internally around your organs (visceral fat). Hormones, in particular testosterone, are negatively impacted by visceral fat, which reduces levels in the body.

Visceral fat produces an enzyme called aromatase. This enzyme has one unfortunate property, making it a hurdle for overweight men. Aromatase takes testosterone (which enables fat-burning and muscle growth) and converts it into estradiol. Ultimately, this conversion slows down testosterone production, and if you already have low testosterone, this further reduces this hormone in the body - making it much harder to lose weight.

What is Insulin Resistance?

Unlike type 1 diabetes, which occurs when the pancreas cannot produce enough insulin, type 2 diabetes develops due to insulin resistance.

Insulin resistance usually occurs in people who are overweight, but not always. You become insulin resistant when your body doesn't respond to insulin as it should. Problems arise because the body starts producing more insulin, which causes high blood pressure, hunger, and weight gain.

Studies show you can increase the body's insulin sensitivity and counteract the problem by significantly reducing added sugar and refined carbohydrate intake. However, a hormone imbalance, particularly one associated with stubborn visceral fat, becomes a roadblock many find hard to overcome. 

What is Metabolic Syndrome?

There are many common symptoms of low testosterone and diabetes (type 2). The most important, visceral fat, is associated with many risk factors commonly grouped under the umbrella of "metabolic syndrome."

Metabolic syndrome is a term for a combination of diabetes, high blood pressure (hypertension) and obesity. It puts you at greater risk of heart disease, stroke and other conditions that affect the blood vessels.

This group of conditions includes:

  1. Abdominal (visceral) obesity
  2. Hypertension (high blood pressure)
  3. Elevated triglycerides (high ''bad'' cholesterol)
  4. Low serum high-density lipoprotein (Low good cholesterol, HDL)
  5. Insulin resistance (leads to type 2 diabetes)

These conditions often cause cardiovascular disease, particularly insulin resistance, which causes type 2 diabetes. TRT and lifestyle changes effectively combat many of the symptoms of metabolic syndrome, including insulin resistance, cardiovascular disease, and type 2 diabetes. 6

Optimizing testosterone levels can help you lose weight and gain control of your insulin sensitivity. Why not take our obligation-free online assessment now to find out if you could benefit from TRT?


What is Prediabetes?

One of the most significant benefits of testosterone therapy is how it can reverse type 2 diabetes and stop diabetes from developing in the first place. The Center for Disease Control and Prevention, National Diabetes Statistics Report, 2020, states that 34.5% of adult Americans (88 million) have prediabetes 5.

Prediabetes is when your blood sugars are higher than they should be but not high enough to be diagnosed with type 2 diabetes. The raised blood sugar increases your risk of developing type 2 diabetes. Often, people with prediabetes have no symptoms.

The same factors cause prediabetes and diabetes, but if you are pre-diabetic, you haven't developed full type 2 diabetes. Studies 4 show that TRT can help stop prediabetes, and for both, the solution is the same - reduce visceral fat by administering testosterone, exercising, and improving your diet.

How Can TRT Help with Low Testosterone and Diabetes (Type 2)?

With a combination of testosterone therapy (TRT) and lifestyle changes, type 2 diabetes is controllable. The latest studies show that TRT is a safe and effective medication that can help stop prediabetes from becoming full-blown, put it into remission, and even reverse it, offering hope to millions of men around the world who have type 2 diabetes.

"The landmark testosterone for diabetes mellitus trial, the largest randomized controlled trial of testosterone therapy (TTh) to date, confirms the beneficial effects of TTh on fat loss and gain in muscle mass, and that TTh for 2 years significantly reduces the risk of incident T2D, and may also reverse T2D."

MonicaCaliber Farid Saad  "Testosterone therapy for the prevention and reversal of type 2 diabetes in men with low testosterone."  Current Opinion in Pharmacology Volume 58, June 2021, Pages 83-89

What are The Benefits of TRT?

  • Healthy heart and blood: improved cardiovascular health, reduced heart attack risk.
  • Less fat and more muscle: reduce potentially harmful visceral fat and diabetes risk.
  • Stronger bones: Reduced osteoporosis risk and risk of broken bones.
  • Healthier mind: Better verbal memory, spatial abilities, or mathematical reasoning: Reduced Alzheimer's disease risk.
  • Improved libido and sexual function: No need for expensive E.D. medications.
  • Improved mood: Reduced risk of depression.

"Studies with testosterone therapy suggest significant benefits in sexual function, quality of life, glycaemic control, anemia, bone density, fat, and lean muscle mass." Hackett G. Type 2 Diabetes and Testosterone Therapy. World J Men's Health. 2019 1

What Can You Do to Avoid or Even Reverse Type 2 Diabetes?

Start Testosterone Therapy to Fight Fat

Fat is the most significant cause of type 2 diabetes. Visceral fat, or the 'hormone belly' as it is known, is usually to blame. By readjusting your hormone balance using TRT, studies show7 you can ease or even reverse many symptoms of type 2 diabetes. You will regain energy levels and increase testosterone, fat-burning, and muscle-building powers. Along with exercise and a healthy diet, it is possible to turn the tide and avoid type 2 diabetes and prediabetes altogether.

Have Regular Exercise

Physically active Men often have higher testosterone levels than those who are sedentary. Therefore, your exercise routine should include not only aerobic exercise but also weightlifting. But be careful not to overdo it. Studies6 show overtraining can also cause adrenal fatigue and lower testosterone levels.

Eat Healthily

Try to eat a balanced diet high in protein, fresh vegetables, and fruit. Also, reducing your sugar intake will promote a healthy weight. Sugar is the single most significant cause of weight gain, so cut it out. A diet high in saturated fats and processed food will knock down testosterone levels and increase visceral and subcutaneous fat, the most significant cause of diabetes. Remember, visceral fat will reduce your testosterone levels, and effective weight loss will be much more challenging without the correct hormone balance.

Reduce Stress Levels

Stress is bad for you. It increases levels of a hormone called cortisol. The hormone directly pushes testosterone levels down. It also facilitates fat distribution straight to your abdomen (visceral fat), reducing testosterone and increasing estradiol from fat. Testosterone replacement therapy will help reduce cortisol levels and aid your ability to cope with stress.

Ensure You Get Enough Vitamin D

In studies, vitamin D effectively increases testosterone levels in men, particularly if you are deficient. Vitamin D also improves insulin sensitivity - regulating blood sugar levels and reducing insulin resistance.

Check your Thyroid Function 

Hormones produced in the thyroid are essential for regulating metabolism and controlling weight and cholesterol. Hypothyroidism (low thyroid) is when your thyroid doesn't produce enough thyroid hormone, slowing down metabolism. Combined with optimized testosterone levels, optimized thyroid hormones make losing weight, burning fat, and reversing insulin resistance easier.

TRT addresses the direct symptoms that cause type 2 diabetes to develop, namely being overweight and the development of visceral fat. But, crucially, TRT also can help deal with the motivation and energy required to do something about it.

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Find Out if TRT Can Help You

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(1) Hackett G. Type 2 Diabetes and Testosterone Therapy. World J Men'sMen's Health. 2019;37(1):31-44. doi:10.5534/wjmh.180027
(2) Grossmann M, Thomas MC, Panagiotopoulos S, Sharpe K, Macisaac RJ, Clarke S, Zajac JD, Jerums G. Low testosterone levels are common and associated with insulin resistance in men with diabetes. J Clin Endocrinol Metab. 2008 May;93(5):1834-40. doi: 10.1210/jc.2007-2177. Epub 2008 Mar 4. PMID: 18319314.
(3) University at Buffalo. (2008, August 30). Young Type-2 Diabetic Men Suffer Low Testosterone Levels, Study Shows. ScienceDaily. Retrieved March 1, 2022 from
(4) Yassin A, Haider A, Haider KS, Caliber M, Doros G, Saad F, Garvey WT. Testosterone Therapy in Men With Hypogonadism Prevents Progression From Prediabetes to Type 2 Diabetes: Eight-Year Data From a Registry Study. Diabetes Care. 2019 Jun;42(6):1104-1111. doi: 10.2337/dc18-2388. Epub 2019 Mar 12. PMID: 30862651.
(5) Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
(6) Brooks K, Carter J. Overtraining, Exercise, and Adrenal Insufficiency. J Nov Physiother. 2013 Feb 16;3(125):11717. doi: 10.4172/2165-7025.1000125. PMID: 23667795.
(7) Jones TH, Arver S, Behre HM, Buvat J, Meuleman E, Moncada I, Morales AM, Volterrani M, Yellowlees A, Howell JD, Channer KS; TIMES2 Investigators. Testosterone replacement in hypogonadal men with type 2 diabetes and/or metabolic syndrome (the TIMES2 study). Diabetes Care. 2011 Apr;34(4):828-37. doi: 10.2337/dc10-1233. Epub 2011 Mar 8. PMID: 21386088; PMCID: PMC3064036.
(8) Monica Caliber, Farid Saad, Testosterone therapy for prevention and reversal of type 2 diabetes in men with low testosterone, Current Opinion in Pharmacology, Volume 58, 2021, Pages 83-89, ISSN 1471-4892, (
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