Understanding the connection between diabetes and erectile health

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Did you know that diabetes affects men at a higher rate than women?

According to the Disease Control and Prevention Centres, men are more likely to receive a diagnosis of diabetes than women.

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There are several key factors that contributes to the susceptibility of diabetes among men such as hormonal differences and body fat distribution. While females have a more favourable effect on insulin sensitivity, there are researches that suggest how estrogen plays a role in enhancing it.

Sunway Medical Centre Velocity (SMVC) Consultant Endocrinologist and Internal Medicine Physician Dr Lim Kim Piow said: "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.”

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Sunway Medical Centre Velocity (SMVC) Consultant Endocrinologist and Internal Medicine Physician Dr Lim Kim Piow

The other contributing factor - fat distribution - is that men often carry excess weight around their abdomen. This visceral fat distribution is associated with a higher risk of insulin resistance, metabolic syndrome and Type 2 diabetes.

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Another aspect of how diabetes affects a man’s overall and well-being life is the link with erectile dysfunction.

SMCV Consultant Urologist Dr Goh Cheng Hood said that after the age of 40, 10 per cent of men develop erectile dysfunction.

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"With the presence of diabetes in men, the risk of developing erectile dysfunction increases 3.5 times compared to non-diabetic patients,” he said.

Getting an erection involves increased blood flow in arteries and reduced blood flow out of veins. With diabetes, it disrupts this process due to neuropathy, decreased nitric oxide levels and increased prothrombin factor.

Dr Lim said that diabetes can lead to erectile dysfunction through two primary mechanisms which are vascular damage and nerve damage.

Vessel diseases, dysfunction, and the accumuation of advanced glycation end products result from hyperglycemia. This impairs the relaxation of the vascular smooth muscle of the penis, ultimately leading to erectile dysfunction.

SMCV Consultant Urologist Dr Goh Cheng Hood

Dr Goh added that erectile dysfunction can lead to emotional consequences too. "For many men, their sense of masculinity and self-esteem is closely tied to their sexual performance, and this is why erectile dysfunction can have a profound impact on self-confidence and self-worth.”

To better manage this, nutrition plays a key role. It is encouraged for men to adopt a diet with plenty of fruits, vegetables and lean proteins while reducing processed food like white bread, instant noodles, or sugary and salty snacks.