Geoffrey Hackett, MD, of Good Hope Hospital in Sutton Coldfield in the UK, and colleagues reported at the World Meeting on Sexual Medicine that testosterone therapy may not be beneficial  in men with type 2 diabetes and hypogonadism who also have depression, but advantageous in the same group without depression.  In a  randomized controlled trial, researchers found that diabetic men who weren't depressed had significant improvements in blood glucose and other metabolic parameters with hormone therapy, but those with depression gained no benefit.

To assess whether treatment of low testosterone is affected by depression, the researchers conducted the randomized controlled BLAST Study (an acronym for the towns of Birmingham, Lichfield, Atherstone, Sutton Coldfield, and Tamworth) in 200 men from seven primary care practices who had type 2 diabetes and hypogonadism. The study lasted 30 weeks, with about half the men continuing in a 52-week, open-label follow-up phase.

Participants were given either 1,000 mg testosterone undecanoate (Nebido) or matching placebo at baseline and at weeks 6 and 18.The prevalence of hypogonadism was 50%. Almost a quarter of the population with type 2 diabetes (23%) was depressed, and these men tended to be younger and more obese, Hackett said.

For men who weren't depressed, testosterone therapy significantly reduced HbA1c levels (P=0.045). It was also tied to significant reductions in weight (P=0.038), body mass index (P=0.02), and waist circumference (P=0.02), the researchers reported.