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Source: American Diabetes Association

Approximately 7.8 million or 8.3% of all men in the United States have diabetes. However, more than one third of these men do not know it. The most life-threatening consequences of diabetes are heart disease and stroke, which strike people with diabetes more than twice as often as they do others. Other complications of diabetes include blindness, kidney disease, and amputations.

Diabetes is the fifth-deadliest disease in the United States, and it has no cure.

Men and diabetes-related complications

Impotence is a sexual dysfunction characterized by the inability to have or keep an erection. In impotence caused by diabetes, the nerves that cause an erection may be damaged or, due to damage of blood vessels, the penile artery may be blocked.

· The prevalence of impotence in men with diabetes over the age of 50 has been reported to be as high as 50-60%.

· Impotence can have a significant psychological component. Concern about sexual ability can often cause impotence even though there is no physiological abnormality. For example, the fear of a heart attack during sex can cause impotence, even though the fear is unfounded.

· Certain medications can cause impotence. For example, some antihypertensive agents (drugs to help control high blood pressure) are known to cause impotence in some men.

· How to help avoid impotence:
  1. Take control of your diabetes. Good blood glucose control can prevent the complications that lead to impotence.
  2. Don’t worry. Fear of becoming impotent can sometimes be the cause.
  3. Avoid drinking excessive amounts of alcohol. Studies show that drinking large amounts of alcohol can cause impotence.
  4. Don’t smoke. Smoking causes blood vessels to constrict, or narrow, and this contributes to artery blockages that can lead to impotence.

Other diabetes-related complications

· Heart disease strikes people with diabetes twice as often as people without diabetes. People with diabetes are five times more likely to suffer strokes and once having had a stroke, are two to four times as likely to have a recurrence. Over the past 30 years, deaths from heart disease in men with diabetes have decreased by only 13% compared to a 36% decrease in men without diabetes.

· In diabetes cases occurring before the age of 30, men develop retinopathy more rapidly than women. Retinopathy is a progressive vision disorder that can lead to blindness. Diabetes is the leading cause of new cases of blindness in adults 20-74 years of age. Diabetes causes from 12,000 to 24,000 new cases of blindness each year.

· Intermittent claudication (the principal symptom of peripheral vascular disease, often manifested by pain in the thigh, calf, or buttocks during exercise) is associated with a two- to three-fold increased risk of coronary heart disease, stroke, or cardiac failure in men with diabetes.

· More than 60% of nontraumatic lower-limb amputations in the U.S. occur among people with diabetes. Amputation rates are 1.4 to 2.7 times higher in men than women with diabetes.

Prevention of complications of diabetes

· Glucose control. Improved blood glucose control benefits people with either type 1 or type 2 diabetes. For every 1% reduction in A1C, the risk for developing microvascular complications (eye. kidney and nerve disease) decreases by 40%.

· Blood pressure control. Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by 33% to 50% and can reduce microvascular disease (eye, kidney and nerve disease) by approximately 33%.

· Control of blood lipids. Improved control of cholesterol and lipids (HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20% to 50%.

· Preventive practices for eyes, kidneys and feet. Detection and treatment of diabetes-related eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%. Comprehensive foot care programs can reduce amputation rates by 45% to 85%.

What Is Needed?

In ideal circumstances, men with diabetes will have their disease under good control and be monitored frequently by a health care team knowledgeable in the care of diabetes.

· Patient education is critical. People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose levels, and receive regular checkups from their health care team.

· Lifestyle changes can be significantly helpful. People with diabetes, with the help of their health care providers, should set goals for better control of blood glucose levels, as well as blood pressure and cholesterol levels, and receive regular checkups from their health care team. Smokers should stop smoking, and overweight men with diabetes should develop a moderate exercise regimen under the guidance of a health care provider to help them achieve a healthy weight.
 
· Health care team education is vital. Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease. A team approach to treating and monitoring this disease serves the best interests of the patient.