ERECTIONS | 3 minutes

The link between diabetes & erectile dysfunction in men

By Duncan Fisher

Erectile dysfunction is common in men that are affected by diabetes. We take a look at why this is, and how you can help to maintain your erectile function if you have it.

Diabetes is a lifelong condition in which your body can’t regulate its blood sugar levels properly. It affects nearly 2 million men in the UK. ‘Type 1’ diabetes is where your body doesn’t make enough insulin, a hormone that helps you break down sugar. ‘Type 2’ is where your body doesn’t use the insulin it makes. Diabetes, especially type 2, is a known risk factor in erectile dysfunction. There are studies that suggest that 35-90% of men with type 2 diabetes eventually develop ED.   

How diabetes can affect your erectile dysfunction

Diabetes contributes to ED in a couple of ways. Over time, the high blood glucose that typifies diabetes gives rise to atherosclerosis, a narrowing and hardening of the arteries that restricts blood flow. It happens because when sugars attach to protein and lipid molecules, they change the shape of those molecules, which means they don’t break down like they’re supposed to, or interact properly with their environment overall.

In other words, your blood vessels aren’t able to work properly. This is a problem, because healthy erections rely on healthy blood flow to the penis.

And there’s a second problem with atherosclerosis. It doesn’t just clog your arteries. The damage it does at the cellular level also leads to a reduction in nitric oxide in your blood. Nitric oxide is one of the chemicals that tells your arteries and the muscles in your penis to relax, which allows more blood to flow, and causes an erection.

So, if your blood sugar is uncontrolled for a long period of time, your blood can’t flow like it should, and your penis can’t do what it’s supposed to. This is diabetes-induced erectile dysfunction.   

How to manage diabetic ED

Keeping your sugar levels controlled (‘glycemic control’ is what it’s called) really matters. This is best managed with the supervision of your doctor or diabetes specialist nurse. Whether you’re on tablets or insulin, there are a few measures which are generally always encouraged. 

If you’re on medication, it’s important to take it exactly as directed, and always keep an eye on your blood sugar levels. If you’re on insulin injections specifically, keeping a diary of blood sugar levels is very important and useful to help you and your doctor or nurse to adjust your doses and keep your sugar levels in check.  

For diabetes, and for erectile function generally, your diet is very important. Part of how you could manage diabetic ED could be to swap ‘high glycemic index’ foods for low ones. For instance, swapping out white breads, highly processed baked goods, or sugary breakfast cereals for things like fruit and vegetables and minimally processed grains. If you need a bit of guidance, it’s best to talk to your doctor or nurse to help you with healthy eating.  

Another part of management is regular exercise. Talk to your doctor first, but getting out and running around can potentially be of help too.

The bottom line

There is a lot you can do. Diabetes doesn’t necessarily have to lead to erectile dysfunction. Understanding what’s going on, and what you can do about it, is key to maintaining healthy erectile function. For individuals who already have ED as a result of diabetes, sildenafil or tadalafil can be an effective treatment

Feature image: istock/bogdaandreava

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