LeeAnna Stock-Luoma RD, LD, CD, CDCES, Author at Dealing With Diabetes

Approximately 90 to 95% of all people with diabetes have type 2, affecting millions of men. Type 2 diabetes, formally known as adult onset diabetes, is the most common form of the disease. If you are a male and are concerned about diabetes, I will go over symptoms in men and explain what to look out for. The symptoms of diabetes in men include: low libido (sex drive), erectile dysfunction, low testosterone, urological problems, and retrograde ejaculation. Additional symptoms may also be present, but first let’s take a look at specific symptoms in men. I will then address additional symptoms that may be present for all diabetics. Libido (Sex Drive) Studies show that men with diabetes have decreased testosterone levels, which can affect their sex drive. Loss of sensation may occur due to nerve damage, also resulting in decreased libido. E.D. (Erectile Dysfunction) Erectile dysfunction is the inability to obtain or maintain an erection. E.D. is the most commonly reported sexual health issue. About half of all men with diabetes will experience E.D. with the diagnosis. Four conditions that accompany diabetes (hypertension, obesity, depression, and inactivity) also contribute to erectile dysfunction. There are over 20 treatments for men including pills, pumps, penile implants, and surgery. Supplemental testosterone is recommended at times. Low Testosterone Men with diabetes often have decreased levels of testosterone, which can affect their sex drive. It has been suggested that men with medical problems or suboptimal health may be at a higher risk to develop low testosterone. Data indicates that men with diabetes are 2.1 times more likely to develop low testosterone. Research about this topic is ongoing. Urological Problems Men with diabetes may experience bladder problems, over or under-active bladder, urinary retention, or urinary tract infections (UTIs). Data suggest that over 50% of both male and females with diabetes will experience bladder problems. Retrograde Ejaculation This happens when semen is ejaculated into the bladder instead of exiting through the penis. Over time, elevated blood sugar levels can cause nerve or muscle damage, including sphincter muscles that are responsible for opening and closing passageways in your body. In addition to the 5 specific symptoms discussed above, other symptoms may present in both males and females. Additional Diabetes Symptoms Symptoms of individuals with diabetes vary from one person to another but often include: Blurred vision. Increased thirst. Increased hunger, especially after eating. Dry mouth. Fatigue. Frequent urination. Dry skin. Nausea. Occasional vomiting. Tingling or numbness of the feet or hands. Non-healing wounds. Frequent infections affecting the urinary tract or skin. Individuals with type 1 diabetes do not produce insulin, thus, these individuals will eventually require insulin injections. Those with type 2 diabetes do produce insulin, but the pancreas does not secrete enough of this hormone or their bodies are unable to recognize and utilize the insulin that is produced, in a condition known as insulin resistance. Whether the diabetes symptoms in men are from insulin levels that are low or not being used properly, it is not possible for glucose, a form of sugar, to provide the energy needed to fuel the cells. As a result, sugar levels in the blood increase but the cells do not function correctly. The increased levels of glucose in the blood can lead to various symptoms and problems. Type 2 diabetes is more common in men than women. However, women tend to have more complications and a greater risk of death. An estimated 14.6% of type 2 diabetics are men, as opposed to 9.1% are women. Men are biologically more susceptible to developing type 2 diabetes. Type 2 diabetes is more frequently diagnosed at a lower age in men than in women. Men tend to develop diabetes at a lower BMI (Body Mass Index) than women of the same age. Research suggests that, despite higher incidence of obesity in women, the diagnosis of type 2 diabetes in middle age men exceeds that of women in the same population. Research also suggests that at any given BMI, men may be less sensitive to insulin than women are. It is believed that this is due to the fat distribution, as men tend to distribute fat more readily around the liver and other organs, where as women tend to deposit fat under the skin in their hips and middle section. It is not possible to determine the biological reasons why men and women develop diabetes at the time they do. The interpretations of researchers are only theories at this time. Who Is Affected? Men of any age or race can be affected by this disease. However, those who are age 45 or older, men who are obese or overweight, individuals with a family history of the disease, and individuals with a sedentary lifestyle are at greater risk. A person with type 2 diabetes is more likely to have additional problems. These include: high cholesterol, low HDL cholesterol (the “good” cholesterol), high LDL cholesterol (the “bad” cholesterol), high triglycerides (fatty like substance that indicates a higher risk of stroke in higher concentrations), and high blood pressure. What Causes this Condition? Type 2 diabetes is due to increased insulin resistance associated with increased weight, sedentary lifestyle, and poor diet. Genetics also plays a role, but it’s not the only factor. An individual may wonder if their diagnosis is due to heredity or lifestyle. Chances are, it’s both. Obesity tends to run in families, obesity tends to accompany type 2 diabetes, and obesity often coincides with a sedentary lifestyle. What Can I Do About? Unfortunately, nothing can be done to change our genetic make up, but we can focus on making more healthful choices in our lives: Aim for 150 minutes of brisk physical activity each week. Start with 10 minutes per day to get started. Check with your physician to make sure it is safe to start an activity plan. Enroll yourself in a smoking cessation program if you are a smoker. Monitor your portion sizes, and try to include more non-starchy vegetables in your diet. Limit your intake of sodium, fatty foods, and excessive deserts. (Schedule an appointment with a registered dietitian, who will help you establish an individualized meal plan.) Replace negative thoughts with positive ones. Stress and worry can be a barrier. Take a deep breath and remind yourself that small changes can make a big difference. Diagnosis When health professionals suspect the possibility of a diagnosis, labs are drawn to reveal blood sugar levels or other abnormalities in the blood. Your doctor may use a casual plasma test or a fasting (abstaining from food or drink for approximately 8 hours) plasma glucose test to diagnose diabetes. In my practice, and according to the American Diabetes Association Standards of Medical Care in Diabetes, the diagnosis of type 2 diabetes is confirmed when a person has two fasting blood glucose results of 126 mg/dL or higher on two separate occasions. Your provider may also order a blood test called a hemoglobin A1c, or simply “A1c.” This test will measure what your average blood glucose (sugar) has been for the past 3 months. An A1c result of 6.5% or greater is also a diagnostic indicator. Diabetes Complications When the condition is not well controlled, it can lead to serious or even life threatening complications. These include: Retinopathy This is an abnormality of the eyes related to the development of diabetes. Even though an individual has no vision problems when initially found to have the condition, many develop problems related to the eyes over time. To prevent progression of vision problems, one should take steps to control blood sugars, hypertension and cholesterol. It is extremely important to get a dilated eye exam every year, as changes in your diabetes can be seen by your optician. If you have never been to an eye doctor or if you feel as though nothing is wrong with your eyes, it is still important to have a dilated eye exam. It will serve as a reference so any potential changes in your vision can easily be compared to your baseline. Kidney damage The risk of developing kidney disease also increases over time. The longer one has diabetes, the greater his or her risk for the disease. With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, the kidneys cannot function properly. Your body will retain more water and salt, leading to weight gain and ankle edema (swelling, fluid retention). Kidney damage can cause significant other serious illnesses, including kidney failure or heart disease. Nerve damage and poor blood circulation The damage to one’s nerves and hardening of the individual’s arteries can decrease feeling and blood circulation to the feet. This leads to greater risk of infections and ulcers which often heal poorly. Untreated ulcers raise the risk of the need for surgery or amputation. Damaged nerves can also lead to problems with the digestive system, including vomiting, nausea, or diarrhea that can also lead to more serious conditions. Final Thoughts If you are experiencing any symptoms, or any combination of symptoms, contact your primary care provider as soon as possible. Catching a diagnosis of diabetes early will help you manage your symptoms, get numbers under control, and identify areas that may need improvement in your life.