By LAURIE KAISER
Published August 23, 2023
Paresh Dandona, SUNY Distinguished Professor of Medicine and chief of the Division of Endocrinology, Jacobs School of Medicine and Biomedical Sciences, has been honored with a Lifetime Achievement Award from the Androgen Society.
The Androgen Society is a professional medical society dedicated to the study of testosterone deficiency (hypogonadism) and its treatment. This new award honors Dandona’s breadth of research on how testosterone deficiency contributes to a reduced response to insulin of glucose lowering and increased insulin resistance, which eventually may contribute to the onset of Type 2 diabetes.
Dandona accepted his award at the Androgen Society’s 2023 annual meeting, held in March in Dallas, where he was the keynote speaker.
“It is a great recognition of our work that we have done over the last two decades in this area,” Dandona says. “We have shown that one-third of Type 2 diabetics and one-fourth of nondiabetic obese males also have low testosterone levels.”
Dandona is the former chief of endocrinology at UB and founder of the Diabetes-Endocrinology Center of Western New York, which is sponsored by the Jacobs School and Kaleida Heath.
In the late 1990s when sildenafil, the first medication to treat erectile dysfunction, hit the market, urologists found that a significant number of patients with diabetes did not respond to the drug. Dandona found at least some of these patients who had low concentrations of testosterone also had Type 2 diabetes. Further systematic investigation revealed that one-third of all patients with Type 2 diabetes had low testosterone levels.
In the ensuing decades, Dandona led several research studies on the connection between the two afflictions, as well as connections between obesity and low testosterone levels. In 2015, his research group demonstrated that men with hypogonadism and Type 2 diabetes had 35% more insulin resistance than those without hypogonadism.
And a study Dandona published in 2016 demonstrated remarkable outcomes: Men who had been treated with testosterone-enhancing drugs, along with their regular diabetes treatment, lost fat, gained muscle and their insulin resistance decreased by one-third, on average.
“It may reverse diabetes itself in about 35% of the patients treated over a period of eight years, which we demonstrated recently in collaboration with our German colleagues,” Dandona explains.
He has also studied the connection between obesity and low testosterone in teens and young adults between the ages 14 of 20. In 2013, Dandona and his team demonstrated that obese boys had testosterone levels that were 50% lower than those in boys within a normal weight range. Dandona and his team of researchers found in a 2022 study of morbidly obese boys that 75% of the subjects had low testosterone.
Over a period of two years when the teens lost weight after bariatric surgery, their testosterone was normalized. Those who regained weight had low testosterone all over again.
“It really is an obesity-based problem, which has to be tackled, and of course, diabetes adds on top of that,” Dandona says. “Because the majority of my patients are middle-aged and past their childbearing years, the impact of low testosterone isn’t as significant. However, when you look at the younger age group, many of whom I expect to be impotent or infertile, the implications are profound.”
If you extrapolate the number of American males who are considered obese, 22 million will also have low testosterone, he says. Worldwide, it’s estimated that between 100 million and 150 million men will fall into this category.
More recently, the team has also pioneered the use of drugs licensed for use in Type 2 diabetes in Type 1 diabetes. Dandona was principal investigator in the global trial of dapagliflozin in Type 1 diabetes. This trial resulted in the licensing of its use in Type 1 diabetes in the U.K., Europe and Japan.
A 2010-11 recipient of the UB Presidential Award for Faculty Excellence, Dandona received a doctorate from Oxford University, where he was a Rhodes scholar. He earned a medical degree from All India Institute of Medical Sciences in New Delhi, the leading medical school in India since its founding nearly 70 years ago. Dandona received the President of India Gold Medal for graduating as the top student.
Dandona came to Buffalo from England in 1991 when UB was looking for a head of endocrinology.
“Since there was no academic endocrinology here at the time, I chose to come here, and we established everything from scratch,” he says. “Our fellowship program was built from zero to one of the largest in the United States. It has been a great journey. Ninety fellows have graduated from our program, and they are spread all over the United States. Our clinical center is now the largest in upstate New York. Our standards of care in diabetes are probably the best in the world, with no major amputations since 1997 and no end stage kidney failure if the patient comes to us with a reasonable kidney function.”