MedPath

The Effects of Semaglutide vs Testosterone Replacement Therapy on Functional Hypogonadism and Sperm Quality in Men With Type 2 Diabetes Mellitus and Obesity

Phase 3
Completed
Conditions
Type 2 Diabetes Mellitus
Obesity
Functional Hypogonadism
Interventions
Registration Number
NCT06489457
Lead Sponsor
University Medical Centre Ljubljana
Brief Summary

The goal of this study is to learn whether semaglutide (treatment for type 2 diabetes and obesity) can improve signs and symptoms of hypogonadism in men with type 2 diabetes, obesity and hypogonadism (a condition when levels of testosterone are decreased).

The main questions the study aims to answer are:

* Does semaglutide improve the quality of sperm?

* Does semaglutide improve symptoms of hypogonadism as well as testosterone replacement?

The researchers will compare semaglutide to testosterone replacement to see which drug better treats symptoms of hypogonadism.

* The participants will receive testosterone replacement therapy (intramuscular injection every 10-12 weeks) or magnitude (subcutaneous injection once a week).

* The treatment will last 24 weeks.

* The participants will visit the clinic at the start and the end of the study.

At the visit, the researchers will measure body weight and take a few blood samples. The participants will also be asked to complete several questionnaires and collect a sperm sample.

The participants are free to terminate their participation in the study at any time without giving a reason.

Detailed Description

Men aged 18 - 65 years with type 2 diabetes on oral antidiabetic treatment, body mass index above 30 kg/m2 and functional hypogonadism (total testosterone below 11 nmol/L and at least 2 symptoms of hypogonadism) are eligible to participate in the study. The participants are randomized to either testosterone undecanoate (100 mg intramuscular injection once per 10-12 weeks) or semaglutide (subcutaneous injection once weekly titrated to 1 mg in concordance with Summary of product characteristics (SmPC) for 24 weeks.

At the beginning of the study and after 24 weeks of treatment the researchers measured anthropometric (body weight, body composition), endocrine (total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG)) and metabolic parameters (HbA1c, 75-g oral glucose tolerance test (OGTT), insulin, c-peptide). The participants also gave sperm samples and completed self-reported hypogonadism symptom evaluation (Ageing male symptoms (AMS) score, International Index of erectile function 15 (IIEF-15)).

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
25
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Testosterone Replacement TherapyTestosterone Undecanoate-
Semaglutide TreatmentSemaglutide-
Primary Outcome Measures
NameTimeMethod
Change in normal sperm forms from baseline and between the treatment armsBaseline and 24 weeks

The normal sperm forms will be assessed as total number of sperm with normal morphology and reported as number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

Change in total number of sperm from baseline and between the treatment armsBaseline and 24 weeks

The total number of sperm will be measured and reported in number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

Change in semen volume from baseline and between the treatment armsBaseline and 24 weeks

The semen volume will be measured and reported in mililiters (mL). The higher the value the better the outcome.

Change in sperm concentration from baseline and between the treatment armsBaseline and 24 weeks

The sperm concentration will be measured and reported in number times 10\^6 per mililiter (10\^6/mL). The higher the value the better the outcome.

Change in total motility of sperm from baseline and between the treatment armsBaseline and 24 weeks

The total motility will be assessed as total number of motile sperm and reported as number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

Secondary Outcome Measures
NameTimeMethod
Change in fasting serum total cholesterol from baseline and between the treatment armsBaseline and 24 weeks

The total cholesterol will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

Change in fasting triglycerides from baseline and between the treatment armsBaseline and 24 weeks

Triglycerides will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

Change in International index of erectile function 15 (IIEF-15) score from baseline and between the treatment armsBaseline and 24 weeks

IIEF-15 assesses male sexual function. It has 5 domains. Erectile function with scoring range from 30 (max) to 1 (min). Orgasmic function with scoring range from 10 (max) to 1 (min). Sexual desire with scoring range from 10 (max) to 2 (min). Intercourse satisfaction with scoring range from 15 (max) to 0 (min). Overall satisfaction with scoring range from 10 (max) to 2 (min). The subdomains combine to overall score with scoring range from 75 (max) to 6 (min). The higher score indicates the better sexual function.

Change in Aging male symptoms (AMS) score from baseline and between the treatment armsBaseline and 24 weeks

The AMS score assesses male symptoms os hypogonadism. It has 3 subdomains. Psychological symptoms with scoring range from 25 (max) to 5 (min). Somatic with scoring range from 35 (max) to 7 (min). Sexual with scoring range from 25 (max) to 5 (min). The subdomains combine to overall score with scoring range from 85 (max) to 17 (min). The lower the score the less symptoms are present.

Change in HbA1c from baseline and between the treatment armsBaseline and 24 weeks

The HbA1c will be measured and reported in % and milimoles per mole (mmol/mol). The lower the value the better the outcome.

Change in follicle-stimulating hormone (FSH) from baseline and between the treatment armsBaseline and 24 weeks

The FSH will be measured and reported in international units per liter (IU/L). The higher the value the better the outcome.

Change in luteinizing hormone (LH) from baseline and between the treatment armsBaseline and 24 weeks

The LH will be measured and reported in international units per liter (IU/L). The higher the value the better the outcome.

Change in fasting serum high-density lipoproteins (HDL) cholesterol from baseline and between the treatment armsBaseline and 24 weeks

The HDL cholesterol will be measured and reported in milimoles per liter (mmol/L). The higher the value the better the outcome.

Change in percentage of body fat from baseline and between the treatment armsBaseline and 24 weeks

Measured by dual-energy X-ray absorptiometry the procentage of body fat will be reported in %. The lower the value the better the outcome.

Change in estimated visceral adipose tissue from baseline and between the treatment armsBaseline and 24 weeks

Measured by dual-energy X-ray absorptiometry the estimated visceral adipose tissue will be reported in grams (g). The lower the value the better the outcome.

Change in fasting serum low-density lipoproteins (LDL) cholesterol from baseline and between the treatment armsBaseline and 24 weeks

The LDL cholesterol will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

Trial Locations

Locations (1)

University Medical Centre Ljubljana

🇸🇮

Ljubljana, Slovenia

© Copyright 2025. All Rights Reserved by MedPath