# Case Report: Lifestyle changes and probiotic supplementation for improving longstanding type 2 diabetes in a male undergoing testosterone replacement therapy

**Authors:** Anna Griffith, Adam Perlman, Tara Karr, Marin Elise Thompson, Orville Kolterman

PMC · DOI: 10.3389/fendo.2025.1754430 · Frontiers in Endocrinology · 2026-01-12

## TL;DR

A 52-year-old man with type 2 diabetes and low testosterone improved his health through lifestyle changes and probiotics, without medication.

## Contribution

Demonstrates successful non-pharmacological management of metabolic syndrome using lifestyle and probiotic interventions.

## Key findings

- Glycemic control improved significantly with hemoglobin A1c dropping from 7.2% to 5.9% in 3 months.
- The patient experienced favorable body composition changes, including fat loss and muscle gain over 6 months.
- Testosterone levels normalized with replacement therapy alongside lifestyle and supplement interventions.

## Abstract

A 52-year-old Caucasian male sought treatment for age-related testosterone decline. Past medical history included diagnosed hypertension and type 2 diabetes mellitus, with suboptimal glycemic control and no current antidiabetic therapy. He qualified for testosterone replacement therapy and agreed to address his metabolic dysfunction through enhanced lifestyle interventions and a targeted 5-strain probiotic as well as other supplements. At 3 months, the patient demonstrated improved glycemic control (hemoglobin A1c decreased from 7.2% to 5.9%) and improvement in newly documented mixed hyperlipidemia. At 6 months, testosterone levels normalized with replacement therapy, and the patient achieved modest weight reduction with favorable body composition changes: 13.2-lb decrease in fat mass, as well as a 6.1% reduction in body fat percentage and a 5.1-lb increase in skeletal muscle mass. This case demonstrates the feasibility and clinical efficacy of combining lifestyle interventions with targeted supplementation in a patient with metabolic syndrome who preferred non-pharmacological management strategies.

## Linked entities

- **Diseases:** type 2 diabetes mellitus (MONDO:0005148), metabolic syndrome (MONDO:0000816), mixed hyperlipidemia (MONDO:0001807)

## Full-text entities

- **Diseases:** hypertension (MESH:D006973), hyperlipidemia (MESH:D006949), type 2 diabetes (MESH:D003924), metabolic syndrome (MESH:D024821), metabolic dysfunction (MESH:D008659)
- **Chemicals:** testosterone (MESH:D013739)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

12 references — full list in the complete paper: https://tomesphere.com/paper/PMC12832501/full.md

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Source: https://tomesphere.com/paper/PMC12832501