Two specific signs of diabetes in men

The rate of diabetes in the U.S. has risen dramatically with one of the biggest jumps in type 2 diabetes was among men. The American Diabetes Association statistics from 2015 show 30.3 million Americans or 1 out of every 10 people have diabetes.  Out of the 30.3 million, one out of every four does not know or has not yet been diagnosed with the disease.

There are many warning signs of diabetes people should be aware of but for men, there are two signs often signaling the possibility of having this chronic disease.

1.     Weight gain in the abdominal area

Whenever a man gains excess weight it almost always accumulates in the abdominal area also known as central obesity.  One thing known is men who put on the pounds are more at risk of developing diabetes than women.  The excess fat pounds men gain are stored as belly fat located deep within the abdominal region in and around major organs like the liver and pancreas.  This deeply stored fat has its own special named called visceral fat.  Visceral fat is harmful and worse for your health than fat located anywhere else in the body.  This type of fat makes it hard for your body to use its own insulin (insulin resistance) and can lead to the development of type 2 diabetes.

Women tend to store fat more directly below the skin known as subcutaneous fat.  They also tend to store fat around the hips and buttocks instead of in the abdominal area.

Any man who has a waist circumference 40 inches or greater has too much visceral fat and is more likely to develop diabetes.

Regardless of whether a man has diabetes or not, having visceral fat puts him in danger of other serious chronic diseases such as cardiovascular disease and stroke.  The solution is to lose weight by eating a healthy diet along with regular exercise helping to reduce his chance of developing diabetes.  Even a weight loss of just 5-7 percent can have a significant impact on his blood sugar levels.

2.     Erectile Dysfunction

The second sign a man may have diabetes has to do with his sex life or lack of – erectile dysfunction.  Men with diabetes are more likely to have erectile dysfunction leading to the inability to achieve an erection or the erection is weak and does not last long enough. 

In order for a man to achieve an erection, there must be good blood flow to the penis and a good nerve supply to make this happen.  Men with diabetes may experience erectile dysfunction because of problems caused by poor long-term blood sugar control causing damage to nerves and blood vessels.  The nerve damage is called neuropathy.  The damaged blood supply affects the stimulation of the nerves that trigger and maintain an erection and the flow of blood into the penis.

Any man experiencing erectile dysfunction should discuss this with their doctor as they can assess and identify what might be the underlying cause of this issue.  It may or may not be due to diabetes but a Hemoglobin A1C test, a fasting plasma glucose test and an oral glucose tolerance test should be performed to rule out the possibility of having this condition. 

Recognizing signs and symptoms of diabetes

Everyone should be familiar with the signs and symptoms of diabetes.  The earlier it is discovered the sooner you can start treating it and reducing your risk of serious medical complications. 

Here are common symptoms of diabetes:

·      Frequent urination

·      Feeling very thirsty

·      Feeling very hungry

·      Extreme fatigue

·      Blurry vision

·      Cuts/bruises that are slow to heal

·      Weight loss even though you are eating more (type 1 diabetes)

·      Tingling, pain, or numbness in the hands or feet (type 2 diabetes)

Priapism – when an erection won’t go away

Some men may read the title and think, “Wouldn’t a long-lasting erection be a good thing?” Be careful what you wish for.  Men who have an erection that won’t give up most likely have a condition called priapism.

Priapism is probably not a commonly known male condition but any man who has ever experienced it will tell you he never wants to have it again.  Excruciatingly painful, priapism is when a man has an abnormal erection in which blood that engorges the penis fails to drain out. Every year emergency rooms see thousands of men with this distressing condition that if an erection lasts too long – more than 4 hours - can do permanent damage to the penis.  In fact, priapism is considered a medical emergency as it could result in a man’s ability to ever have an erection again. 

Two types of priapism                

There are two types of priapism – ischemic priapism and nonischemic priapism. 

1.     Ischemic priapism is the most common form and occurs when blood is not able to flow back out of the penis.  The symptoms of this type include:

·      An erection lasting more than four hours that is not due to sexual stimulation

·      The penile shaft is very rigid but the glans or tip of the penis is soft.

·      The pain becomes progressively worse with time

One main cause of this type of priapism is sickle cell anemia.  This is an inherited disorder known for its abnormally shaped red blood cells or sickle cells.  These cells block the blood vessels in the penis refraining blood to flow back out of an erect penis.  Another possible cause is due to taking medication for achieving an erection such as Viagra but this is considered rare. Leukemia, Multiple Myeloma, and Non-Hodgkin Lymphoma have also been known to cause this type of priaspism.

Prescription medications are also associated with ischemic priapism which include:

·      Antidepressants

·      Medication injected directly into the penis to treat erectile dysfunction

·      Blood thinners such as warfarin

·      Hormones such as testosterone

·      Medications to treat attention-deficit disorder (ADHD)

2.     Nonischemic priapism is when penile blood flow isn’t regulated normally.  This type is usually painless with symptoms that include:

·      Erection lasting more than 4 hours that is not due to sexual stimulation

·      The penis is erect but not as rigid as in ischemic priapism.

Harmful effects of priapism

Ischemic priapism can lead to possible complications.  An erection lasting more than 4 hours means blood trapped in the penis will be deprived of oxygen.  When blood can’t circulate and carry oxygen to the cells that make up the structures of a man’s penis, those cells start to die which can result in tissue damage, scar tissue and in extreme cases if not treated, can lead to permanent erectile dysfunction.

When to see a doctor

Anytime an erection has lasted more than 4 hours and or a man is in excruciating pain, it is time to seek emergency care. At the ER, a doctor will determine if the prolonged erection is due to ischemic or nonischemic priapism.  The reason for this is each type has a different treatment - ischemic priapism needs to be treated right away.

Treatment for priapism

If priapism is considered ischemic, there are several ways it can be treated:

·      The excess blood can be drained from the penis using a small needle and syringe helping relive pain removing oxygen-poor blood. 

·      A sympathomimetic drug may be injected into the penis constricting blood vessels carrying blood into the penis. 

·      Surgery may be performed if other treatments do not help.  This would involve rerouting blood flow so the blood flows into the penis normally.

Nonischemic priapism usually goes away on its own without treatment.  This type of priapism does not cause any risk to the penis as ischemic priapism can.  One treatment possibly used could be putting ice packs and pressure on the perineum which is found between the base of the penis and the anus to stop the erection.