Low testosterone is associated with increased fat mass (especially metabolically harmful abdominal fat) and muscle loss, increasing the risk of type 2 diabetes. Hormone imbalances worsen with age, prompting some men to seek treatment for low testosterone or type 2 diabetes. The endocrine system is complex, but let’s look at how the hormones affected in diabetes are related to the sex hormone, testosterone, and the stress hormone, cortisol.
Low testosterone causes changes in body composition. These changes are associated with a reduced ability to control blood glucose, reduced insulin sensitivity, and elevated cholesterol. Unfortunately, these metabolic factors increase your risk for heart disease, high blood pressure, and stroke.
Exercise and losing excess weight can increase testosterone levels and improve insulin sensitivity and glucose utilization. A healthy diet and exercise are the best ways to counteract hormone imbalance. However, if you see signs that your hormones may be a bit “off,” talk to your healthcare providers. Sometimes, having your hormone levels tested to see if they are abnormally high or low gives you the data you need to proactively change your life.
In this article, learn how the roles of cortisol, insulin, and testosterone are related. See how hormone imbalances can be linked to type 2 diabetes and how these metabolic changes affect men’s health.
Cortisol, produced by the adrenal glands, is commonly called the stress hormone. When your body is under stress, whether mental or physical, cortisol is released to prepare for “fight or flight.” Your heart rate and breathing increase, as does blood flow to your muscles. Body systems such as the reproductive and gastrointestinal systems receive less blood flow.
Your body also mobilizes glucose to make it available to hard-working muscle cells. Cortisol inhibits insulin release, so glucose is not stored in the liver. Cortisol also prods the liver to convert proteins into glucose via a process called gluconeogenesis. Though the direct connection between increased cortisol and type 2 diabetes is unclear, it makes sense that a stressful lifestyle and cortisol overproduction increase blood sugar and insulin resistance.
Insulin and glucagon are opposing hormones that regulate blood sugar. Insulin lowers blood glucose by ushering it into body cells, where it can be used for energy. Glucagon does just the opposite. Beta cells in the pancreas produce insulin. If they cannot produce insulin, it is called type 1 diabetes. People with type 1 diabetes must replace insulin every day either through insulin shots or a device that delivers a continuous supply of insulin.
If the pancreas can produce insulin but not enough to meet the body’s needs or the body cells are resistant to the effects of insulin, it is called type 2 diabetes. Initially, your pancreas responds by pumping out more and more insulin to keep your blood sugar stable. However, blood glucose rises when the pancreas can no longer keep up. Increased blood glucose leads to damage to small blood vessels throughout the body.
Testosterone affects the activity of enzymes in adipose (fat) tissue, muscle, and mitochondria in every cell. Mitochondria are tiny powerhouses that convert the energy from food into ATP, the energy currency your body uses to function. Low testosterone levels are associated with obesity, but there is also evidence that the inverse is true: obesity affects testosterone levels. Waist circumference is also inversely related to testosterone levels.
Hypogonadism (low testosterone) is defined as having at least two low testosterone measurements taken before 10:00 am, along with signs and symptoms that can be attributed to low testosterone.
Hormonal imbalance can become a vicious cycle, with low testosterone increasing the risk of obesity, further lowering testosterone. Adipose tissue is chemically active, especially fat surrounding organs. It releases hormones, such as leptin, and inflammation-stimulating factors, such as tumor necrosis factorα (TNFα) and interleukin 6 (IL6).
Adiponectin is a hormone that is linked to both type 2 diabetes and obesity. In this case, higher levels are good. Low adiponectin is associated with insulin resistance. Increased insulin levels and insulin resistance precede type 2 diabetes.
Several clinical studies support the relationship between testosterone and increased risk for diabetes. When men with low testosterone were given testosterone replacement therapy (TRT), their insulin resistance improved, and they had better blood sugar control. Researchers found that low testosterone predicted future insulin resistance and type 2 diabetes. Type 2 diabetes is linked to an increased risk of cardiovascular disease.
In another study, researchers concluded that TRT decreased central obesity and improved blood sugar control. Finally, a third study showed that aging men with obesity and metabolic syndrome have lower testosterone levels than age-matched men without obesity.
The effects of insulin, cortisol and testosterone are all intertwined. Weight gain leads to decreased testosterone, a process that feeds back on itself. Both weight gain and low testosterone increase insulin resistance, which increases the risk of developing type 2 diabetes.
Chronic stress causes increased insulin resistance. Starving body cells call for more food, and changes in the hormones released from fat cells lead to weight gain.
Lifestyle modifications are the safest and best place to start when trying to balance your hormones.
Eat a healthy diet to decrease inflammation and naturally regulate your hormones, choose:
Avoid foods and drinks that lower testosterone levels for men, such as:
Hormones are chemical messengers that circulate throughout the body. Hormone levels fluctuate, affecting organ systems throughout the body. Start with lifestyle changes if you are not metabolically healthy and suspect you have a hormone imbalance. Next, talk to your doctor about your concerns, and consider getting your hormone levels checked with the men’s standard hormone panel.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.