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.

Testosterone therapy was associated with significantly lower risk of acute kidney injury in men with diabetes and hypogonadism.

• HR: 0.93 (95% CI 0.87–0.98), p = 0.01
• Study included 26,027 testosterone-treated diabetic men with hypogonadism matched 1:1 to 26,027 untreated diabetic men with hypogonadism
• Propensity score matching was used to balance groups
• Mean follow-up was 3.3 years; mean age was 58 years (SD 12); 71% were non-Hispanic White

Testosterone therapy was associated with significantly lower risk of kidney failure requiring replacement therapy (dialysis or transplantation).

• HR: 0.81 (95% CI 0.72–0.92), p = 0.001
• Kidney failure with replacement therapy was a primary outcome alongside acute kidney injury
• Participants were identified from the TriNetX Research Collaborative network
• Cox proportional hazard models were used to estimate risk over the follow-up period

Testosterone therapy was associated with reduced risk of myocardial infarction.

• HR: 0.85 (95% CI 0.78–0.93), p < 0.0001
• Myocardial infarction was a prespecified secondary outcome
• Analysis was conducted over a mean follow-up of 3.3 years

Testosterone therapy was associated with reduced risk of ischemic stroke.

• HR: 0.88 (95% CI 0.80–0.97), p = 0.01
• Ischemic stroke was a prespecified secondary outcome
• The cohort consisted of men with both diabetes and hypogonadism

Testosterone therapy was associated with reduced risk of atrial fibrillation.

• HR: 0.91 (95% CI 0.85–0.98), p = 0.01
• Atrial fibrillation was a prespecified secondary outcome
• Results were obtained using Cox proportional hazard models in the propensity-score matched cohort

Testosterone therapy was associated with reduced all-cause mortality in diabetic men with hypogonadism.

• HR: 0.85 (95% CI 0.79–0.91), p < 0.0001
• All-cause mortality was a prespecified secondary outcome
• The matched cohort included 52,054 total participants (26,027 per group)

The study used a large real-world cohort design with propensity score matching to compare testosterone-treated and untreated diabetic hypogonadal men.

• Participants were recruited from the TriNetX Research Collaborative network
• 26,027 diabetic men with hypogonadism treated with testosterone were matched 1:1 to 26,027 untreated diabetic men with hypogonadism
• Mean age was 58 years (SD 12), with 71% being non-Hispanic White
• Mean follow-up was 3.3 years
• Cox proportional hazard models were used for analysis