Everything you need to know about diabetes in men

Warning signs of diabetes | Diabetes symptoms in men | Prostate health | Risk of diabetes men | Treatments

An estimated 34.2 million people in the U.S. have diabetes, according to a 2020 report by the Centers for Disease Control and Prevention (CDC). That works out to about 10.5% of the population, making diabetes one of the most common chronic conditions in America and one of the country’s leading causes of death and disability.

For men, the numbers are slightly worse than they are for women. Diabetes affects 11% of men, versus 9.5% of women, and the CDC believes that another 3.1% of American men have diabetes and don’t know it. Diabetes can affect males differently, too.

Diabetes is a chronic health condition that can lead to many health problems (some life-threatening) if not treated properly. Therefore, prompt recognition and treatment of diabetes can make a huge difference in someone’s prognosis. If you think you might be at a risk, keep an eye out for the early signs of diabetes in men.

Warning signs of diabetes

There are four main types of diabetes (medically known as diabetes mellitus): Type 1, Type 2, gestational diabetes, which can affect women while they are pregnant, and prediabetes. Type 1 diabetes is less common and occurs when someone’s pancreas produces little to no insulin, a hormone that helps regulate blood glucose levels (glucose is the main sugar found in the blood). It can affect people of any age, but it’s most prevalent in children and adolescents. Type 2 diabetes accounts for about 90% of all diabetes cases and is most common in adults. It occurs when one’s body doesn’t make good use of the insulin the pancreas produces.

RELATED: Type 1 vs. Type 2 diabetes

“The warning signs and common symptoms of Type 2 diabetes can be very insidious and sneaky,” says Debbie Hinnen, an advanced practice nurse and certified diabetes care and education specialist with UCHealth. “It’s not always obvious that something is wrong.”

Common symptoms of Type 1 and Type 2 diabetes that affect both men and women include:

• Frequent urination
• Extreme fatigue
• Blurry vision
• High blood pressure
• Excessive thirst
• Feeling very hungry
• Unexplained weight loss
• Numb or tingling hands
• Dry skin or skin infections
• Bruises or sores that are slow to heal
• More infections than usual
• Glaucoma, cataracts, diabetic retinopathy, and other eye complications
• Urinary tract infections and incontinence
• Thrush (candida), a yeast infection of the skin, usually around the genitals or mouth

People with Type 1 diabetes may also experience nausea, vomiting, or stomach pains. These symptoms can develop quickly—in just a few weeks or months—and may be severe.

Diabetes symptoms in men

While many symptoms of diabetes are similar in both men and women, there are some signs specific to men. These symptoms include erectile dysfunction, low testosterone, and retrograde ejaculation.

Erectile dysfunction (ED) 

Thanks to ads for medications like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil), most men are well aware of ED, a condition where a man can’t keep an erection firm enough for sex. A sexual dysfunction, ED is common in middle-aged and older men, affecting as many as 30 million men in the U.S. alone. 

According to the CDC, men with diabetes are three times more likely to get ED. This can be due to blood flow problems in the veins and arteries due to cardiovascular disease caused by either Type 1 or Type 2 diabetes. 

RELATED: Diagnosing erectile dysfunction

Low testosterone

Problems associated with Type 2 diabetes symptoms in men also include low testosterone. According to the American Diabetes Association, men with Type 2 diabetes are twice as likely to have low levels of testosterone, a hormone produced mainly in the testes. Low testosterone can lead to ED, diminished interest in sex, depressed mood, lack of energy, and a reduction in lean muscle mass.

Retrograde ejaculation

This uncommon problem occurs when semen produced in the testes goes backward into the bladder instead of the urethra (the tube that carries urine from the bladder to the penis). Retrograde ejaculation can cause infertility that may require medical treatment. Both Type 1 and Type 2 diabetes can put men at greater risk of retrograde ejaculation by causing nerve damage (neuropathy) in the bladder.  

Diabetes and prostate health

Diabetes can affect prostate health in men. Research shows that men with Type 2 diabetes have lower risk of developing prostate cancer, but when it occurs, the mortality rate is higher. Additionally, elevated blood glucose levels are associated with prostate enlargement. Men with diabetes were over twice as likely to have an enlarged prostate than those without.

Risk factors for diabetes in men

Although they have similar symptoms, Type 1 diabetes and Type 2 diabetes each have different risk factors. 

Doctors believe that Type 1 diabetes is caused by an immune system reaction that causes the body to attack itself. The causes of Type 1 diabetes are largely genetic, so family history is an important consideration. If you have a family member with Type 1 diabetes, you are at higher risk of also developing it yourself. Another risk factor is age. Although you can develop Type 1 diabetes at any age, it develops most commonly in children, teens, and young adults.

Since Type 2 diabetes has less to do with genetic factors and more to do with lifestyle choices, it’s most common in adults 45 and older. 

“Type 2 diabetes can develop at any age, but increases in prevalence with aging,” says Ruth Weinstock, MD, PhD, president of medicine and science with the American Diabetes Association.  “In general, the younger the individual is when diagnosed with diabetes, the greater the likelihood of requiring more intensive therapy and developing diabetes-related complications over time.”

Other risk factors for Type 2 diabetes include:

• Prediabetes (a condition where blood sugar levels are elevated but not yet diabetic level)
• Obesity, or being overweight
• Engaging in physical activity less than three times a week 
• Alcohol or tobacco use
• Having a direct family member (parent or sibling) with Type 2 diabetes
• Non-alcoholic fatty liver disease 

Race can also play a factor. Native Alaskans and other Native Americans, African Americans, and Latin Americans all have an increased risk of developing Type 2 diabetes. 

Diabetes treatments

Currently, Type 1 diabetes can’t be prevented, but most cases of Type 2 diabetes are preventable and can be managed successfully with diet and lifestyle changes. It’s important to seek treatment as soon as you are diagnosed—or notice symptoms.

If diabetes is allowed to go untreated for many years, it can lead to serious long-term health complications. “The risk for damage to the eyes, nerves in the body, the kidneys, and blood vessels in the heart, brain, and legs increases with elevated blood sugar levels, especially when present for prolonged periods of time,” says Dr. Weinstock. 

Home remedies for treating Type 2 diabetes include:

• Losing weight. Weight loss helps keep down blood sugar levels, cholesterol, blood pressure, and triglycerides (a type of fat found in the blood).
• Eating a healthier diet based on vegetables, fruits, and whole grains while avoiding excess sugar and carbohydrates.
• Quitting or cutting back on alcohol or tobacco use.
• Getting aerobic exercise. All adults should try to get at least 30 minutes of aerobic exercise on most days.
• Getting resistance exercise. Adults with Type 2 diabetes should aim for two or three sessions of strength and agility training each week.
• Limiting inactivity. Break up long periods of sitting in a chair by standing and moving around for a minute or two every half-hour.

Type 1 diabetes and advanced cases of Type 2 diabetes may require blood sugar monitoring and insulin therapy—a treatment involving ingesting or injecting fast-acting or long-lasting insulin supplements. If you get diagnosed with diabetes that requires this type of treatment, your healthcare provider will advise you on how, and how often, to use an at-home blood glucose meter to check your blood sugar levels. If you take insulin, you may have to do this multiple times a day and increase your insulin intake if the numbers are too high.

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Medications that may be prescribed to help manage diabetes include:

In addition to medications that treat diabetes directly, doctors may also prescribe drugs to treat diabetes symptoms or complications of diabetes. This may include medications to treat ED, lower blood pressure, help with weight loss, or treat heart disease or kidney disease. End stage kidney disease, from long standing untreated diabetes, may require visits to a healthcare facility for dialysis treatment. During dialysis, the blood is pumped through a machine that filters glucose out of the blood and helps do the work of the kidneys.