The Connection Between Low Testosterone And Blood Sugar

Low testosterone and blood sugar are tied together more closely than most men expect. Many men with type 2 diabetes also have low testosterone, more often than men without diabetes (University at Buffalo, 2020). The two problems tend to push on each other, and catching that pattern early is one reason many men get their hormone and metabolic markers checked at the same time through a telehealth provider focused on hormone health.

The link between low testosterone and blood sugar runs mostly through insulin resistance. Insulin is the hormone that tells cells to pull sugar out of the blood after a meal. When testosterone sits low, cells respond to insulin less well, so sugar leaves the blood more slowly and stays higher for longer (Grossmann, 2014).

That single mechanism explains a lot of what follows.

Can low testosterone raise blood sugar?

It can be. In men, low testosterone is associated with higher insulin resistance, which may raise blood sugar.

Insulin resistance means cells stop answering insulin the way they should. Glucose then moves into tissues much more slowly, so it lingers in the blood after meals. Testosterone may play a role in how cells take up glucose, so low levels could contribute to slower uptake.

Body fat is part of the loop too. Visceral fat, the fat packed deep around the organs, is closely linked with both lower testosterone and greater insulin resistance (Grossmann, 2014). Each can make the other a little worse, which is how a small dip can turn into a real pattern over a few years.

Plenty of men in this spot also notice symptoms of low testosterone like flat energy, lower sex drive, and lost muscle. Those symptoms are usually what sends a man to get tested in the first place.

Does low testosterone cause type 2 diabetes?

Not exactly. Low testosterone and type 2 diabetes travel together, but research hasn't shown that one clearly causes the other.

A meta-analysis of 13 studies covering more than 16,000 men found that higher testosterone went with a lower risk of developing type 2 diabetes. The authors read that pattern as likely reverse causation: the diabetes, and the extra body fat behind it, may be dragging testosterone down rather than the other way around.

This changes how men should think about treatment. In many men carrying extra weight, low testosterone may be functional, and losing weight can sometimes raise levels without medication (Grossmann, 2014). The honest read is that the link is real and runs in both directions. Low testosterone is better seen as a warning light that travels with metabolic trouble than as a single cause of it.

Lab numbers need context, too. Ranges vary between labs, and symptoms don't always match the figure on the page, which is why a man's reference ranges tell only part of the story.

Testosterone therapy for men with diabetes in 2026

Testosterone therapy is for men with a confirmed deficiency. It isn't a blood-sugar drug, and it shouldn't be started to manage diabetes.

Some research looks promising. In one long-term observational study of men who had both type 2 diabetes and low testosterone, some who received testosterone saw better blood sugar control. The men weren't randomly assigned, though, and the picture isn't settled. The AUA advises clinicians to consider checking testosterone in men with diabetes, but it doesn't back testosterone as a diabetes treatment (Mulhall et al., 2018), and the trial evidence on blood sugar stays mixed (Grossmann, 2014).

Diagnosis comes first. It generally involves symptoms plus blood testing repeated on separate mornings and interpreted by a provider, before therapy is on the table (Bhasin et al., 2018; Mulhall et al., 2018). There's no single universal cutoff, and what counts as low is decided for each person. One low reading isn't enough. Getting the right hormone panel drawn and read correctly is a step many men skip, and it shapes the decisions that follow.

Whether to start testosterone is an individual decision, made with a provider who weighs the likely benefits against the risks for that specific person.

What lab monitoring does testosterone therapy need?

Testosterone therapy needs steady lab work, because some risks can show up in bloodwork before a man notices symptoms.

Providers order routine bloodwork during therapy and adjust care based on the results, since testosterone can affect several values over time. Blood pressure gets specific attention. In February 2025, the FDA updated the labeling on testosterone products, removing the old blanket heart-risk warning and adding a blood pressure warning in its place. That change followed the TRAVERSE trial. In that trial of men with low testosterone and heart risk, testosterone didn't increase major cardiac events compared with placebo, though some other risks (such as irregular heart rhythm, kidney injury, and blood clots) were higher (FDA, 2025; Lincoff et al., 2023).

Beyond the labs, testosterone therapy can bring side effects worth tracking:

• higher red blood cell count

• fluid retention

• prostate enlargement

• acne

• blood clots

• worse sleep apnea

Regular lab work is an important part of safe therapy. Skipping the follow-up tests is exactly where home or gray-market testosterone gets men into trouble.

Managing low testosterone and blood sugar together

Managing both conditions together starts with the habits that move them at once: weight, food, activity, and sleep.

For many men, the same changes help both numbers. Losing extra body fat can raise testosterone and improve insulin sensitivity, sometimes enough that a prescription isn't needed (Grossmann, 2014). The basics still win here. More vegetables and less added sugar. Regular walking with some resistance training added in. Less alcohol.

Diabetes medication stays in the picture, and any testosterone plan has to be coordinated with it, since treating one condition can affect the other. Access has limits, too. Testosterone is a controlled medication, and as of publication, temporary federal rules let providers prescribe it through telehealth without an in-person visit, currently through the end of 2026, though this can change and state laws vary.

GLP-1 medications, now common for metabolic health, often come up in the wider conversation about weight and blood sugar, and they sit alongside the same lifestyle work rather than replacing it.

The bottom line on testosterone and blood sugar

Low testosterone and high blood sugar are worth evaluating together. The strongest move isn't chasing a testosterone prescription. It's getting both checked, with symptoms in the picture, so the real driver shows up. For some men, that driver is a true testosterone deficiency that deserves treatment and close monitoring. For many others, it's metabolic, and the answer is often the weight, food, and activity that can lift testosterone and steady blood sugar at the same time. Either way, the connection between low testosterone and blood sugar is a reason to get tested and work with a licensed provider, not a reason to guess.

Disclaimer: This blog post is intended for informational purposes only and should not be considered medical advice. Always consult a healthcare professional before making changes to your health routine.

FAQs

How are low testosterone and blood sugar connected? 

Low testosterone and blood sugar are connected mainly through insulin resistance, which can make cells slower to clear sugar from the blood. The overlap is common: many men with type 2 diabetes also have low testosterone. The two conditions tend to affect each other over time.

Can low testosterone raise blood sugar? 

It can be a contributing factor. Low testosterone is associated with higher insulin resistance in men, which may slow how the body clears sugar from the blood, so levels can run higher after meals. Testosterone may play a role in how cells take up glucose, so blood sugar can drift up when levels fall.

Does testosterone therapy treat type 2 diabetes? 

No. Testosterone therapy isn't a diabetes treatment and shouldn't be started to control blood sugar. Some men who have both conditions and receive testosterone see better blood sugar control, but the strongest studies weren't randomized and the overall evidence stays mixed.

What testosterone level is considered low? 

Low testosterone is defined by blood testing interpreted alongside symptoms, repeated on separate mornings. There isn't a single universal cutoff, and a provider determines what counts as low for a given person. A single reading isn't enough to start therapy.

Can weight loss improve low testosterone and blood sugar? 

For many men, yes. Losing extra body fat can raise testosterone and improve insulin sensitivity at the same time, sometimes enough that medication isn't needed. Weight, diet, activity, and sleep are first-line steps for both conditions.

Is testosterone therapy safe for the heart? 

Cardiovascular safety should be individualized. In a large trial of men with low testosterone and heart risk, testosterone didn't increase major cardiac events compared with placebo, though some other risks were higher. The FDA updated labeling in 2025 to remove the older blanket heart-risk warning and add a blood pressure warning, so anyone with heart concerns should weigh this with a provider.

Can men get testosterone therapy through telehealth? 

Yes, with a proper evaluation and lab confirmation. As of publication, temporary federal rules let providers prescribe testosterone, a controlled medication, through telehealth without an in-person visit, currently through the end of 2026, though this can change and state laws vary. Treatment is appropriate only when a deficiency is confirmed.

References

• Diabetes Obes Metab. 2020

• Endocr Connect. 2018;7(1)

• J Clin Endocrinol Metab. 2018;103(5):1715–1744

• J Endocrinol. 2014;220(3):R37–R55

• J Urol. 2018;200(2):423–432

• N Engl J Med. 2023;389(2):107–117

• U.S. Food and Drug Administration. Class-wide labeling changes to testosterone products. 2025