Impotence in Diabetics
By Gabe Mirkin, M.D.
More than 50 percent of diabetic men suffer from impotence, and almost all
complain bitterly that it has destroyed something that is very important
to them. Impotence caused by diabetes can be prevented or reversed in
almost all men whose bodies can still make insulin.
Diabetes causes horrendous nerve damage including blindness, deafness,
burning foot syndrome, loss of feeling, loss of muscle control, pain and
tingling and impotence. The penis is the only gland in the body that has
its blood supply shut off all the time. Muscles surrounding the penile
artery constrict the artery to prevent blood from flowing to the penis.
When a man is excited, his brain sends messages along nerves that cause
the nerves to secrete a chemical called nitric oxide theat relaxes the
muscles around the arteries to open blood flow to the penis and the
balloons in the penis fill with blood and the man has an erection.
More than 90 percent of diabetics who can still make their own insulin can
be controlled so that they do not suffer nerve damage. When you eat, your
blood sugar level rises. If it rises too high, sugar sticks to cells and
causes permanent nerve damage. Doctors can measure how much sugar is stuck
on cells with a blood test called HBA1C. To get your HBA1C to a normal
range below 6.1, you have to avoid foods that cause a high rise in blood
sugar such as those with added sugar, those made from flour such as bakery
products and pastas, and fruit juices.
Most cases of nerve damage from diabetes can be reversed by good control
of diabetes, but sometimes the damage is permanent. For example once
person goes blind from diabetes, he will never get his vision back.
However, impotence is often reversible with good control of diabetes.
Men who are impotent from diabetes must be seen every month and each
month, the doctor must draw a blood test called HBA1C which measures
diabetic control for the last 12 weeks, or another blood test called
fructosamine, which measures diabetic control over the last 2 weeks. Every
time, the HBA1C is greater than 6.1, the doctor must change the patient's
drugs and the patient must change his diet.
All diabetics should get a blood test called C-peptide to tell if their
bodies can make insulin. If their C peptide is greater than 1, they should
not be placed on insulin and should be started immediately on Glucophage
and Actos or Avandia. These drugs lower high blood sugar levels, never
cause low blood sugar, and also lower insulin to prevent obesity and heart
attacks. Only if blood sugar levels cannot be controlled by diet and these
insulin-lowering drugs should doctors prescribe drugs that raise insulin.
For my recommendations on treatment of diabetes see
http://www.drmirkin.com/diabetes/D222.html
Dr. Gabe Mirkin has been a radio talk show host for 25 years and
practicing physician for more than 40 years; he is board certified
in four specialties, including sports medicine. Read or listen to
hundreds of his fitness and health reports at
http://www.DrMirkin.com
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