Diabetes and erectile dysfunction are closely linked to each other and to cardiovascular disease. Along with obesity, diabetes is also an epidemic in the United States. It's estimated that there are sixty million Americans who have diabetes; many people don't even know they have it. In our clinical practice of male and female sexual dysfunction, we are often the first practitioners to make the diagnosis of diabetes. Diabetes and erectile dysfunction have a direct relationship.
Diabetes and erectile dysfunction
Diabetes is categorized into two types: Type I diabetes (sometimes called juvenile diabetes) and Type II diabetes.
Type I Diabetes
Type I diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States; it develops most often in children and young adults but can appear at any age. Type I diabetes is an autoimmune disease which results when the body's system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. It's not known for certain what causes the body's immune system to attack the beta cells, but autoimmune, genetic and environmental factors, possibly viruses, are involved.
The beta cells in the pancreas produce insulin and regulate our blood sugar balance. When they are destroyed, the body's ability to maintain a balance of insulin and blood sugars is altered. With the death of beta cells in the pancreas, the body has no insulin and is therefore unable to process food stuff and blood sugars become high. Before the discovery of insulin, people often died. With the discovery of insulin, we have been able to control Type I diabetes. Unfortunately, controlling Type II diabetes is not that simple.
Type II diabetes
Type II diabetes is much more common. About 90 to 95 percent of people with diabetes have Type II. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity and certain ethnicities. About 80 percent of people with Type II diabetes are overweight.
In Type II diabetes, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for Type I diabetes—glucose builds up in the blood and the body cannot make efficient use of its main source of fuel. Patients with either type of diabetes will eventually end up taking insulin.
Diabetes is not just about blood sugar. Diabetes can affect lipid levels and can cause obesity. People taking insulin will have an increased weight gain because of insulin's appetite stimulating effects.
Connection between diabetes and erectile dysfunction
Diabetes has a well-documented profound effect on endothelial dysfunction; uncontrolled diabetes is a leading cause of endothelial dysfunction. Diabetes can cause inflammation of the heart, or early cardiovascular disease. An important reminder is "if it's good for the heart, it's good for the penis." Inflammation is certainly not good for the heart, thus we can say it is not good for the penis or for a healthy sex life.
One very important study looked at men with diabetes who were able to maintain their erections. These men had no greater risk of having a subsequent silent heart attack than the general population. The men with diabetes who could NOT maintain erections were eight times more likely to have a silent cardiovascular event than the men with diabetes who could maintain an erection. This is profound.
Diabetes, cardiovascular disease and erectile dysfunction are closely linked.
References: See Bibliography
August 2006
Posted August 2008
Updated August 2009
