Response to Letter to the Editor: "Androgens, Irregular Menses, and Risk of Diabetes and Coronary Artery Calcification in the Diabetes Prevention Program".

Thank you for the comment noting a potential role for dehydroepiandrosterone-sulfate (DHEAS) in mitigating diabetes risk. Previous analyses in the Diabetes Prevention Program have examined the relationship between DHEAS and incident diabetes (1,2), before and after adjustment for risk factors, including age. No association was seen before or after adjustment. It is possible that DHEAS is associated with lower diabetes risk in populations with a wider range of body mass indices and levels of glucose tolerance. As for the role of DHEAS therapy, several randomized trials have not demonstrated noteworthy effects with DHEAS supplementation (3). It is possible that exogenous DHEAS concentrations have different metabolic effects than DHEAS produced by the adrenal glands.