The Role of Dehydroepiandrosterone in Diabetes Mellitus

Abstract

Much has been written in the lay literature regarding potential benefits of dehydroepiandrosterone (DHEA). Although it was removed from the over-the-counter market in 1985, the Dietary Supplement Health Education Act of 1994 allowed the drug to be marketed as a food supplement. Because DHEA no longer falls under the scrutiny of the Food and Drug Administration, many unverified claims have been put forth in the press espousing its therapeutic value. This barrage of "infomercials" has left the average American consumer (and health care professional) curious about DHEA and its possible therapeutic utility. One focus of recent research is to define the role of DHEA in diabetes mellitus. Although it has been claimed that decreased levels of endogenous DHEA are associated with diabetes, impaired glucose tolerance, hyperglycemia, and insulin resistance, much of the information is based on cross-sectional studies. Other claims correlate decreased endogenous DHEA levels with adverse cardiovascular effects. Some information is contradictory and indicates high doses of exogenous DHEA may produce adverse cardiovascular effects, an undesirable outcome in patients with diabetes mellitus. At this time, its administration in patients with diabetes is not warranted. Long-term trials evaluating the role of exogenous DHEA and its effect on patients with diabetes should be conducted.

Impact of glycemic variations on the regulation of androgen metabolism in obese women with polycystic ovary syndrome

“…Not only increased T levels have been linked to impaired glucose tolerance, but also the adrenal androgen concentrations (10). Levels of DHEA were significantly lower in our PCOS group compared with healthy controls, which can be explained by the reduced glucose tolerance in the PCOS patients.…”

“…Levels of DHEA were significantly lower in our PCOS group compared with healthy controls, which can be explained by the reduced glucose tolerance in the PCOS patients. Cross-sectional studies have shown that decreased levels of endogenous DHEA are associated with diabetes, impaired glucose tolerance, hyperglycemia, and insulin resistance (10).…”

Dehydroepiandrosterone Stimulates Glucose Uptake in Human and Murine Adipocytes by Inducing GLUT1 and GLUT4 Translocation to the Plasma Membrane

“…In addition, DHEA has been shown to restore insulin sensitivity in obese Zucker rats (42) and to protect against the development of insulin resistance in rats fed a high-fat diet (14). Whereas the data in rodents clearly indicate a beneficial effect of DHEA on insulin sensitivity, studies in humans have yielded less clear results (43). For the first time, this study shows a stimulatory effect of DHEA on glucose uptake by human fat cells that occurs through GLUT4 translocation to the cell surface.…”

Dehydroepiandrosterone prevents oxidative injury induced by transient ischemia/reperfusion in the brain of diabetic rats.

“…Several roles, including the increase of neuronal and glial survival and differentiation, have been attributed to these neuroactive steroids (17,18), but the mechanism(s) responsible for these effects is not yet known. Although DHEA at very high pharmacological doses has been found to induce oxidative stress in rats by acting as a peroxisome proliferator (19), evidence indicates that at concentrations slightly above those found in human tissues, DHEA possesses a multitargeted antioxidant effect (20)(21)(22)(23) and prevents tissue damage induced by acute (7) and chronic hyperglycemia (24,25). Moreover, we recently showed that DHEA treatment restores the redox state in synaptosomes of diabetic rats (26).…”