As a diabetes educator and registered nurse, I continue to be surprised by how many male patients I encounter who are unaware that they have diabetes. In some cases, a spouse or partner notices changes and encourages them to seek medical attention. Others discover they have diabetes only after a major health event, such as a stroke or heart attack, leads to hospitalization.
According to the Centers for Disease Control and Prevention (CDC), men are less likely than women to visit a healthcare provider regularly. Many men avoid medical appointments because they fear receiving bad news about their health. However, when it comes to diabetes, early detection and proactive management are essential to preventing serious complications.
Type 2 diabetes is often referred to as a “silent disease” because symptoms can develop gradually or may not be noticeable at all. The CDC estimates that millions of adults with diabetes remain undiagnosed.
Over time, elevated blood glucose levels can damage blood vessels and nerves throughout the body. When diabetes is left undiagnosed or poorly managed, it can increase the risk of heart disease, stroke, vision loss, kidney failure, neuropathy, and lower-extremity amputations.
According to the American Diabetes Association (ADA), erectile dysfunction (ED) is a common health concern among men with diabetes, affecting approximately 52% of men with the condition. In some cases, ED may be one of the earliest signs of diabetes. It is also strongly associated with cardiovascular disease (CVD). Men experiencing ED should be evaluated for cardiovascular risk factors, as ED can be an important predictor of future cardiovascular events in both men with and without diabetes.
While diabetes can contribute to ED, it is not the only cause. Other factors may include certain blood pressure medications, low testosterone levels, psychological stress, or emotional concerns. Diabetes-related ED often develops gradually over months or years. Fortunately, several effective treatment options are available, including medications, testosterone replacement therapy when appropriate, vacuum erection devices, injections, and penile implants. A healthcare provider can help determine the underlying cause and recommend the most appropriate treatment. Most men can be successfully treated and regain satisfactory sexual function.
Stress and anxiety can further worsen ED. Seeking support from a mental health professional may help individuals and couples cope more effectively with these challenges.
Diabetes-related nerve damage can also contribute to other urological complications, including overactive bladder, urinary tract infections, and retrograde ejaculation, which may affect fertility. Maintaining blood glucose levels within target ranges is important for reducing the risk of nerve damage and other complications. The ADA generally recommends a fasting blood glucose target of 80–130 mg/dL, although goals may vary depending on age, type of diabetes, and individual medical circumstances.
The Mayo Clinic reports that men with diabetes may also face a higher risk of certain urological cancers, including kidney and prostate cancer.
The ADA offers a diabetes risk assessment tool on its website that can help individuals evaluate their personal risk. You may also consult your healthcare provider for a simple blood glucose test. The ADA recommends screening for diabetes beginning at age 35. Earlier screening may be appropriate for individuals with a body mass index (BMI) of 25 or greater, or 23 or greater for people of Asian ancestry.
If test results are normal, screening is generally recommended every three years. Individuals with prediabetes (A1C 5.7%–6.4%) should be tested annually. Early detection and treatment can significantly reduce the risk of long-term complications and improve overall health outcomes.
