The role of dehydroepiandrosterone in diabetes mellitus

Much has been written in the lay literature regarding potential benefits of dehydroepiandrosterone (DHEA). Although it was removed from the over-the-c ounter market in 1985, the Dietary Supplement Health Education Act of 1994 allowed the drug to be marketed as a food supplement. Because DHEA no longe r falls under the scrutiny of the Food and Drug Administration, many unveri fied claims have been put forth in the press espousing its therapeutic valu e. This barrage of "infomercials" has left the average American consumer la nd health care professional) curious about DHEA and its possible therapeuti c utility. One focus of recent research is to define the role of DHEA in di abetes mellitus. Although it has been claimed that decreased levels of endo genous DHEA are associated with diabetes, impaired glucose tolerance, hyper glycemia, 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 patient s with diabetes should be conducted.