The association between use of GnRH agonists and increased risk of type 2 diabetes has also been established and is also supported by several proposed underlying mechanisms, such as the low testosterone level induced by GnRH agonists.11,12 The US Food and Drug Administration issued a safety warning, requiring labeling on GnRH agonists warning of the increased risk of diabetes.36 Type 2 diabetes is associated with an increased risk of CVD and related mortality.37 Thus, GnRH agonists need to be used with caution in men with type 2 diabetes. This evidence concerns the gene GNRH1 and type 2 diabetes mellitus.