On the Lookout: Diabetes Symptoms in Men

Diabetes symptoms in men can mirror those in women, but there are some differences, as we discuss here. It helps to first understand what diabetes is: a condition characterized by elevated blood glucose levels, which can lead to a number of serious complications.

In people without diabetes, the pancreas produces the hormone insulin, which acts on the body’s cells, moving “sugar,” or glucose, from the blood into the cells, where it can be used for energy.

• In type 1 diabetes, the body’s immune system attacks and destroys the cells in the pancreas that produce the hormone insulin resulting in an insulin deficiency and therefore elevated blood glucose levels.
• In type 2 diabetes, the cells of the body become resistant to the effects of insulin and the pancreas cannot produce enough extra insulin to compensate for this resistance, resulting in high blood glucose levels.

According to the American Diabetes Association, studies have demonstrated that men are more likely to develop type 2 diabetes than women, although the reasons for this are unclear.

Men share many of the same risk factors for diabetes as women, including family history, the presence of autoantibodies, living in a colder climate, and possibly exposure to certain viral illnesses for type 1 diabetes and obesity or excess weight, older age, family history, race, sedentary lifestyle, high blood pressure, and abnormal cholesterol levels.

In addition, some researchers believe that diabetes symptoms in men increase with low testosterone levels, which increases the risk for developing insulin resistance or type 2 diabetes. Other scientists think low testosterone is a complication of type 2 diabetes. Either way, there is a definite link between the two with research demonstrating that men with type 2 diabetes are twice as likely to have low testosterone levels as men without diabetes.

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Diabetes Symptoms in Men

While men experience many of the classic diabetes symptoms that women experience such as increased thirst, increased urination, fatigue, and blurred vision, there are some diabetes symptoms in men that are unique.

• Erectile Dysfunction (ED): Men with diabetes are 2 to 3 times more likely to experience impotence or erectile dysfunction than men without diabetes. There is some evidence that suggests ED may be an early sign of diabetes in men 45 years old and younger. There are two possible causes of ED in men with diabetes. The body’s response to sexual stimuli is involuntary and mediated by nerves that are called autonomic nerves. Diabetes can damage these nerves leading to ED. Additionally, diabetes can also damage the blood vessels that allow an erection to occur resulting in ED. It is important to note that there are other causes of ED including some medications, high blood pressure, and cardiovascular disease. If you have diabetes and develop ED, you should consult with your healthcare provider to determine the cause.
• Retrograde ejaculation: In retrograde ejaculation some or all of a man’s semen enters the bladder instead of being released from the tip of the penis. This is caused by nerve damage that affects the internal muscles, also called sphincters, that normally prevent semen from entering the bladder. Retrograde ejaculation does not affect orgasm, but may cause fertility problems.
• Recurrent genital thrush: Elevated blood sugar levels can lead to increased yeast infections of the penis, resulting in redness, swelling, itchiness, and discharge around the head of the penis.
• Reduced lean muscle mass: Men with diabetes may experience a loss of lean muscle mass. This is particularly true for men with diabetes who also have low testosterone levels.

Metabolic syndrome–characterized by a pear-shaped or apple-shaped body type–is an early warning sign of pre-diabetes and diabetes.

Complications in Men with Diabetes

Men can suffer from many of the same complications of diabetes as women including heart disease, nerve damage or neuropathy, eye damage, kidney damage, and foot problems. Some studies have demonstrated that men with diabetes suffer from the complications of stroke and kidney disease more than women, but other studies have not demonstrated this. Men can also experience additional complications:

• Infertility: Men who suffer from retrograde ejaculation may have problems with fertility.
• Reduced libido: Men who suffer from low testosterone or erectile dysfunction may experience diminished interest in sex.

What Can Men Do to Avoid Diabetes Complications?

All people with diabetes are encouraged to maximize control of their blood glucose levels, adopt a healthy, balanced diet, increase their physical activity, and maintain a healthy weight to increase their odds of avoiding diabetes complications. In addition, men should consult with their urologist to discuss treatment options for symptoms like ED which can include medications, the use of pumps, and even surgery.

Men with retrograde ejaculation wishing to father a child can seek help from a urologist specializing in fertility issues who may be able to collect sperm from urine and utilize it for artificial insemination. Low testosterone levels can easily be treated with hormone injections, patches, or gels.

Following your healthcare provider’s recommendations for diabetes management, understanding the signs of complications, and listening to your body so that you can identify symptoms of diabetes are all valuable steps any man with diabetes should take.

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