Risks and Complications of Type 2 Diabetes in Men


Type 2 diabetes (T2D) is a complex chronic disease that develops when the body loses its ability to properly use and produce the hormone insulin. As a result, the body does not regulate blood sugar effectively. Chronically high blood sugar is toxic to blood vessels and organs, such as the eyes, kidneys, and heart.

Your specific symptoms will depend on the organ affected. For example, eye damage can lead to blurry or double vision, and kidney damage can lead to more frequent urination.

Research shows that men are more likely than women to develop type 2 diabetes, highlighting the importance of looking for early male-specific signs, such as erectile dysfunction and retrograde ejaculation, and taking medications. measures to prevent diabetes in this high-risk population.

This article discusses the risks and complications of type 2 diabetes in men.

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According to the Centers for Disease Control and Prevention (CDC), 1 in 10 people, or nearly 40 million adults in the United States, live with type 2 diabetes. There are potentially many people who unknowingly live with type 2 diabetes or prediabetes.

Type 2 diabetes is more common in men and women over the age of 45, but diabetes rates are increasing in all populations, including children, adolescents and young adults.

Diabetes is a public health crisis

Major public health associations such as the American Public Health Association and the CDC have considered type 2 diabetes a public health crisis.

Men are particularly at risk – the prevalence of type 2 diabetes in men is 14.6% compared to 9.1% in women – because they carry more abdominal fat. Belly fat is a known primary risk factor for type 2 diabetes. It promotes insulin resistance, which decreases the efficiency of insulin delivery in the body. Over time, the pancreas produces higher and higher amounts of insulin until it can’t anymore.

Also, men tend to develop type 2 diabetes at a younger age than women. Although the exact cause is unknown, the main reason points to higher amounts of abdominal fat compared to women, although biological, socio-cultural, economic and lifestyle factors also play an important role.

It should be noted that obesity is the greatest risk factor for type 2 diabetes.

Predicting diabetes risk in men

Waist circumference – a measurement of abdominal adiposity (excess fatty tissue in the body) – as well as measurements of visceral fat (fat around your organs like the heart and liver) have been shown to be superior in calculating body mass index (BMI) in predicting diabetes in men.

Below are the potential complications of type 2 diabetes in men.


Men with type 2 diabetes are more likely to have trouble getting or keeping an erection, a condition called erectile dysfunction (ED).


Erectile dysfunction is very common in men with type 2 diabetes. In fact, one study reports that more than half of men with type 2 diabetes also report having erectile dysfunction.

Chronically high blood sugar is toxic to the nerves and blood vessels of the body. Damage to nerves (autonomic neuropathy) and blood vessels (atherosclerosis) affects muscle and nerve function.

Damage to autonomic nerves that control the body’s automatic responses – such as the nerves in the penis that help induce an erection during sexual arousal – as well as narrowing of blood vessels in the penis due to atherosclerosis are the main cause. of erectile dysfunction.


Controlling your diabetes with a combination of lifestyle changes and medications, such as insulin and/or metformin, is key to preventing and treating erectile dysfunction.

Common oral drugs of the class of phosphodiesterase-5 (PDE-5) enzyme inhibitors, such as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) are first-line drugs for dysfunction erectile.

They work by relaxing the muscles of the penis and promoting blood flow by blocking PDE-5, an enzyme that restricts blood flow. Managing other medical conditions like high blood pressure and high cholesterol is also likely to help improve your erectile dysfunction symptoms.

It should be noted that if oral medications and lifestyle changes do not relieve your erectile dysfunction symptoms, your health care provider may recommend other options such as:

  • A penis pump
  • Intraurethral suppository
  • Vacuum pump
  • Penile implant

Medical treatment for erectile dysfunction should always be done under the guidance of a medical professional.

Dysfunction of the autonomic nervous system (ANS)

Diabetic autonomic neuropathy (DAN) – the primary and most severe form of ANS dysfunction – occurs when the nerves that control the body’s automatic functions are damaged and stop working properly.


DAN can affect your blood pressure, heart rate, temperature control, and even your sweating.

Organ systems throughout the body that may be affected include:

  • Digestive system: The esophagus, stomach, and large and small intestine are the most commonly affected organs and symptoms may include esophageal enteropathy, gastroparesis, constipation, diarrhea, and faecal incontinence.
  • Genitourinary system: The bladder and penis are the most commonly affected organs and urinary incontinence, erectile dysfunction and retrograde ejaculation are among the most common resulting symptoms.
  • Cardiovascular system: Symptoms of cardiac autonomic neuropathy are subtle and can range from a drop in blood pressure when you stand up (orthostatic hypertension) to a “silent” or asymptomatic heart attack (also called myocardial infarction).


There is no single treatment for DAN.

DAN affects the whole body.

Treatment is based on the organ most affected by nerve damage. Therefore, you can take a number of medications aimed at treating your diabetes (and any other underlying conditions) and managing your specific symptoms.

Retrograde ejaculation

Retrograde ejaculation is a common symptom of T2D which is characterized by semen entering the bladder instead of exiting through the penis during orgasm.

Often, retrograde ejaculation has no symptoms except for cloudy urination after sex and, more rarely, difficulty having a child, a sign of infertility.

Decreased or damaged sperm

Research has shown that men with diabetes not only have lower sperm counts but may also have a higher likelihood of damaged sperm due to epigenetic changes in sperm DNA and disturbances in glucose metabolism.

Therefore, poorly managed diabetes can have a detrimental effect on male fertility, even in the absence of erectile dysfunction.

Urological problems

Type 2 diabetes can cause urological problems in men, including:

  • Overactive bladder: Nerve damage can send mixed messages to the bladder, causing it to spasm and leak at unpredictable times.
  • Incontinence: Chronically high glucose levels can damage the nerves in the bladder (neuropathy) leading to loss of bladder control.
  • Urinary Tract Infections (UTI): These are more common in men with type 2 diabetes, but they are also more severe and have poorer outcomes compared to people with UTIs without type 2 diabetes.


If you have type 2 diabetes, managing your blood sugar with a combination of lifestyle changes centered on diet, exercise, and medication will be the best way to avoid serious medical complications.

Meeting with a diabetes counselor can help you formulate a plan that works best for you. This diet may include:

  • Developing a heart-healthy diet that focuses on a healthy balance of good carbs and fats and low sodium
  • Exercise regularly
  • Test your blood sugar and keep track of results
  • Recognize the signs of high or low blood sugar and what to do about it
  • Learn to provide you with insulin, if needed
  • Take diabetes medications, such as metformin, and learn the importance of medication adherence
  • Attend a diabetes education course
  • Checking your feet, skin and eyes to catch problems early
  • Buy diabetes supplies and store them properly
  • Limit or avoid stressful situations
  • Managing other medical conditions that may make your diabetes worse or vice versa.

In addition to attending regular appointments with a healthcare professional, connecting with support groups and discussing your journey with family and friends can also provide you with the support and encouragement you need. to best adapt to these new lifestyle changes.


Men are more likely than women to develop type 2 diabetes, which underscores the importance of looking for early male-specific signs, such as erectile dysfunction and retrograde ejaculation, and taking steps to prevent the onset of diabetes. diabetes in this high-risk population.

A word from Verywell

Type 2 diabetes can affect anyone, regardless of age, weight or eating habits. Getting regular wellness visits from a trusted health care provider is one of the best ways to develop a health plan to reduce your risk of diabetes.

Frequently Asked Questions

  • Is type 2 diabetes more common in men or women?

    Men are more likely than women to develop type 2 diabetes, underscoring the importance of watching for male-specific early signs such as erectile dysfunction and retrograde ejaculation, and they are also more likely to develop type 2 diabetes earlier in life.

  • Can diabetes interfere with ejaculation?

    Erectile dysfunction is one of the most common medical complications of type 2 diabetes. In addition, high blood sugar can affect glucose metabolism and lead to genetic changes in sperm, reducing sperm count and quality during ejaculation.


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