Diabetics and Erectile Dysfunction

 According to a 1998 survey, 9% of the adult population in Singapore suffers from diabetes, a group of diseases that impairs our ability toprocess sugar.

Under normal conditions, the body secretes insulin, which allows glucose in the blood (from digested food) to enter the cells in our body to be utilised for energy. In a diabetic, the body either cannot produce insulin (Type 1 diabetes); does not produce enough, or that his body does not respond to insulin (Type 2). As a result, glucose accumulates in the bloodstream and passes out in urine.

The incidence of diabetes between men and women are roughly similar; but for men, diabetes brings with it a problem that some consider, rocks the very centre of manhood: erectile dysfunction (ED).

A guy thing

Erectile dysfunction, or impotence, is the inability to muster an erection, or to sustain one through sexual intercourse. Causes of erectile dysfunction are varied, from physiological to psychological; often one exacerbates the other in a vicious cycle... impotence causes performance anxiety, which further degrades sexual performance.

That said, there is a very close link between ED and diabetes. Indeed, ED often serves as an early warning sign for diabetes, since it is not uncommon for diabetics to show little obvious symptoms and remain undiagnosed till they’ve had the disease for several years.

 A causal connection

An erection begins with sexual stimulus. When a man is sexually stimulated, neurotransmitters are released in the penile area, which relaxes the smooth muscle in the erectile tissue. When this happens, the central artery in the penis widens, allowing blood to flood into the penis; at the same time, veins carrying blood out from the penis are constricted, producing a sustained erection from blood trapped in the penis.

Diabetes disrupts this mechanism at several points, via the following:

•    nerve damage

•    blood vessel damage

•    excessive levels of sugar in
     the blood

 High levels of sugar in the blood damages the walls of small blood vessels, so that the damage done by diabetes is very wide. Where ED is concerned, diabetes damages the nerves in the penile area when it damages the tiny blood vessels that nourish them. Without the nerve signals required to trigger an erection, the mechanism cannot start.

Damaging the blood vessels impairs blood circulation, on which an erection depends. Moreover, high sugar levels in the blood can also inhibit the production of neurotransmitters responsible for causing an erection.

As a result of these complications, 75 per cent of men with diabetes develop ED as compared to 25 per cent in the general population; and where men without diabetes most often develop ED from age 65, diabetic men develop it 10-15 years earlier.

Tailored solutions

Nevertheless, while there remains no conclusive cure for diabetes, almost every case of impotence can be corrected, via a number of means.

Consult your doctor: Naturally, the first step is to consult a doctor, who can help ascertain the cause of ED, to what extent it is diabetes-related or is a result of some other condition or lifestyle choice.

Control blood sugar: High blood sugar levels can damage nerves and blood vessels, causing ED among other serious health problems. Check with a doctor on medication to curb blood glucose levels.

Get healthy: For some, this might involve a lifestyle overhaul. In general, abstaining from substance abuse (tobacco, alcohol) losing weight and exercising has the sum effect of improving cardiovascular health so critical in sustained erections.

The following are remedies directly addressing ED:

Self-Injection: Involves injecting a drug through the side of the penis, producing an erection in 5-15 minutes that could last anywhere from 30 minutes to several hours.

Vacuum devices: A pump contraption, an erection is created by generating a vacuum to draw blood into the penis, and sustained by placing a rubber ring around the base of the penis.

Drug therapy:  Comparatively more convenient than other remedies, there are a few drugs taken orally that can help ED.

Cialis: works on the same principle as Viagra, but a chief benefit is its longlasting effect–taken without regard to food, Cialis works within 30 minutes and stays effective for up to 36 hours. In trials, Cialis was shown to improve erections in 85 per cent of men tested. It was also shown to be effective against diabetes-related ED, improving erections in 64 per cent of diabetic men.

Viagra: a superstar of the pharmaceutical industry, Viagra is not without its limitations. It works best on an empty stomach, and should be taken around an hour before sexual intercourse. This severely limits spontaneity. Moreover, it may interact with certain cardiovascular medication and side effects include headache, blue-tinged vision and facial flushing. In trials, Viagra was found to improve erections 60-70 per cent of the time.

Levitra: can take effect in as little as 10 minutes, though most men will need 25 minutes, and it stays effective for 5-6 hours. Works independently from food intake, the most common side effects include headache and facial flushing.

A very high percentage of diabetic men will suffer from erectile dysfunction among other health problems. For men with diabetes to enjoy healthy sex lives, the most suitable remedy should be picked in consultation with a doctor, to find the solution that is effective, yet least disruptive to other complications brought on by diabetes, and the medication they are currently on •