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Not So Sweet: Understanding The Unspoken Connection Between Erectile Health and Diabetes

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In light of November being Men’s Health Awareness Month, Sunway Medical Centre Velocity (SMCV) is taking the initiative to shed light on a pressing health concern that affects men at a higher rate than women – Diabetes. According to the Centers for Disease Control and Prevention (CDC), men are more likely to receive a diagnosis of diabetes than women. Moreover, with World Diabetes Day approaching on 14 November, let us delve into the intricate link between Type 2 diabetes mellitus and men’s health, with a specific focus on how diabetes can contribute to Erectile Dysfunction (ED), impacting men’s overall well-being.

Men and Diabetes: A Closer Look
This increased susceptibility of diabetes among men can be attributed to several key factors, including hormonal differences and body fat distribution. Hormonally, females have a more favourable effect on insulin sensitivity, with research suggesting that estrogen plays a role in enhancing it. Sunway Medical Centre Velocity (SMCV) Consultant Endocrinologist and Internal Medicine Physician, Dr Lim Kim Piow explains, “Testosterone enhances glucose-stimulated insulin secretion and reduces inflammation, leading to improved beta cell health. However research has shown that lower testosterone levels in men are associated with a greater risk of Type 2 diabetes.”

Another contributing factor is body fat distribution. Men often carry excess weight around their abdomen, a pattern known as central obesity. Visceral fat distribution is associated with a higher risk of insulin resistance, metabolic syndrome and Type 2 diabetes. “Low testosterone level in men can increase visceral fat leading to increased risk of Type 2 diabetes compared to women.” Dr Lim adds.

ED and Diabetes: An Unspoken Challenge
While the management of blood sugar is a central concern in diabetes care, it is crucial to recognise that diabetes is not limited to its physical manifestations. It can have far-reaching effects on a man’s overall well-being and quality of life, with one such consequence being Erectile Dysfunction (ED). Sunway Medical Centre Velocity (SMCV) Consultant Urologist, Dr Goh Cheng Hood highlights the connection, “After the age of 40, 10% of men develop ED, and as age increases, so does the risk. With the presence of diabetes in men, the risk of developing ED increases 3.5 times compared to non-diabetic patients.”

Getting an erection involves increased blood flow in arteries and reduced blood flow out of veins. Diabetes disrupts this process due to neuropathy, decreased nitric oxide (NO) levels, and increased prothrombin factor, causing reduced blood flow and blood vessel clotting.

Diabetes can lead to ED through two primary mechanisms: vascular damage and nerve damage. Dr Lim further explains that vessel diseases, dysfunction, and the accumulation of advanced glycation end products result from hyperglycemia. This impairs the relaxation of the vascular smooth muscle of the penis and ultimately leading to ED.

Besides the physical impact, the emotional consequences of ED are often underestimated. It can strain intimate relationships leading to communication issues and emotional distance between partners. Dr Goh adds “For many men, their sense of masculinity and self-esteem is closely tied to their sexual performance, and this is why ED can have a profound impact on self-confidence and self-worth.”

However, this should not deter men from seeking professional help before their condition progresses into a severe form. Dr Goh emphasises that 21% of male patients with ED experience severe dysfunction. Beyond its impact on the quality of life, ED can also lead to psychological challenges, such as the development of severe depression disorders. Thus, he strongly highlights the importance of early medical attention.

The Role of Nutrition
Effective diabetes management involves nutrition. To support this, Sunway Medical Centre Velocity (SMCV) introduces the Better Days Recipe Booklet. It features delicious yet healthy and diabetes-friendly recipes that focus on controlling the “3 Highs”: High Blood Sugar, High Blood Pressure, and High Cholesterol. These recipes help manage diabetes and contribute to overall well-being by stabilising blood sugar levels and potentially positively affecting ED.

Dr Lim strongly agrees the critical role that nutrition plays in managing diabetes and overall health. He recommends a well-balanced diet that is low in carbohydrates, sugars, and trans fats while being rich in protein, fiber, and essential nutrients. “This diet should include plenty of fruits, vegetables, and lean proteins. It is also advisable to reduce the consumption of processed foods and high glycemic index (GI) items like white bread, instant noodles, processed meats, and sugary or salty snacks.”

However, maintaining a healthy diet doesn’t mean sacrificing taste or variety. There are numerous healthy and fresh options available in the market, such as green leafy vegetables, whole grains, fatty fish, legumes, nuts, and fruits, providing ample room for dietary preferences and customisation.

Conclusion
This November, Sunway Medical Centre Velocity (SMCV) urges everyone to understand the multifaceted nature of diabetes and how it can affect men’s overall well-being, including the potential risk of erectile dysfunction.

Both Dr Goh Cheng Hood and Dr Lim Kim Piow encourage men to overcome hesitation and share their concerns with medical professionals who understand the challenges they face. In a society where this topic remains taboo and lacks widespread education, it is essential to recognise that healthcare providers are here to provide support. They are well-equipped to assist patients on their journey to better health. Open and honest conversations helps in dispelling doubts and clearing away misconceptions. These dialogues not only foster better diabetes management but also serve as a vital tool for public education, ultimately reducing the risk of developing ED.


This article is contributed by Dr Lim Kim Piow, Consultant Endocrinologist and Internal Medicine Physician, and Dr Goh Cheng Hood, Consultant Urologist of Sunway Medical Centre Velocity (SMCV), and does not represent the views or opinions of Health Matters Malaysia.


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